Which factor should prompt checking CA-125 when evaluating a pelvic mass?

Which factor should prompt checking CA-125 when evaluating a pelvic mass?

• A. Always check CA-125 for any pelvic mass.
• B. Only in postmenopausal women.
• C. There are risk factors for malignancy.
• D. CA-125 is never useful.

Answer: (C)

CA-125 is a tumor marker used to help assess the likelihood that a pelvic mass is malignant, but its value depends on the pretest probability of cancer. When there are risk factors for malignancy—such as being older (often over 50), a strong family or personal cancer history, or genetic risk like BRCA mutations—the chance that a pelvic mass is cancer is higher. In this context, checking CA-125 adds information that helps stratify risk and guide next steps (further imaging, referral to gynecologic oncology, or planning surgery). Routinely testing CA-125 for every pelvic mass isn’t ideal because many benign conditions (endometriosis, fibroids, pelvic inflammatory disease) can raise CA-125, and some early cancers may have normal CA-125. So the presence of risk factors is the key factor that makes CA-125 testing most meaningful.

CA-125 is a tumor marker used to help assess the likelihood that a pelvic mass is malignant, but its value depends on the pretest probability of cancer. When there are risk factors for malignancy—such as being older (often over 50), a strong family or personal cancer history, or genetic risk like BRCA mutations—the chance that a pelvic mass is cancer is higher. In this context, checking CA-125 adds information that helps stratify risk and guide next steps (further imaging, referral to gynecologic oncology, or planning surgery).

Routinely testing CA-125 for every pelvic mass isn’t ideal because many benign conditions (endometriosis, fibroids, pelvic inflammatory disease) can raise CA-125, and some early cancers may have normal CA-125. So the presence of risk factors is the key factor that makes CA-125 testing most meaningful.