Cancer Antigen (CA) 125
Medical Test

Diseases (14)
Screening/Initial Testing (1)
Ovarian cancer screening
7
Note:

May be considered in patients with suspected or known familial cancer syndrome(s). Typically testing is every 6 months beginning at age 30.

Diagnostic Testing (9)
Disease Management Testing (3)
Other Supportive/Alternative Tests (1)
Cancer of unknown primary site
6
Note:

Aid in diagnosis and management of ovarian cancer.

Overview

CA 125 is a cell surface protein often found on ovarian cancer cells and in some normal tissues. It is one of the protein antigens that has been associated with the presence of various cancers, but is most often positive in ovarian cancer. CA 125 concentrations may also be elevated in other types of non-cancerous conditions, including menstruation, pregnancy, and pelvic inflammatory disease. CA 125 is a useful tumor marker for evaluating therapy and monitoring disease status in ovarian cancer patients. As the levels decrease it is an indication that the therapy or treatment is working. Post-operatively, the CA 125 concentration correlates with tumor bulk and is a prognostic indicator of clinical outcome. It has been reported that patients with levels exceeding 35 U/mL have the highest risk for clinical recurrence. CA 125 is not useful as a screening mechanism because it is elevated in many non-cancerous conditions, although women that are at higher risk due to family history or other reasons are usually tested regularly as a precautionary method.

Measured serially, serum CA 125 concentration typically corresponds with disease progression or regression. The rate of change in CA 125 is also highly prognostic. A rapid decrease in the level of CA 125 indicates a positive response to treatment. Elevated levels of CA 125 after the third course of primary chemotherapy are typically predictive of poor outcomes.

Clinical Utility
  • Monitoring and management of ovarian cancer of epithelial type, including monitoring for disease after initial treatment.
  • Management of ovarian epithelial cancer patients with metastatic disease by monitoring the progression or regression of disease response to treatment

Interpretation

Increased in:

  • Ovarian cancer of epithelial types
  • Pelvic inflammatory disease
  • Some other cancers
  • Cancer of endometrium
  • Cancer of fallopian tube
  • Some physiological conditions such as pregnancy, menstruation
  • Endometriosis
  • Ovarian cysts

Note: Normal levels do not exclude recurrent malignancy.

Reference Ranges

 <30 U/mL

 

 

Methodology

Enzyme Immunoassay, ELISA

Specimen Collection

Serum (SST)

Stability:

  • Ambient: 24 hours
  • Refrigerated: 7 days
  • Frozen: 60 days
  • Separate sample within 1 hour of collection and keep refrigerated or frozen.

Additional Testing

Carcinoembryonic antigen (CEA), CA 15-3, CA 19-9, Follicle Stimulating Hormone, Luteinizing Hormone, HCG, Progesterone, HE4.

CPT
86304$ 20.81

ICD10
C25Malignant neoplasm of pancreas
C25.0Malignant neoplasm of head of pancreas
C25.1Malignant neoplasm of body of pancreas
C25.2Malignant neoplasm of tail of pancreas
C25.7Malignant neoplasm of other parts of pancreas
C25.9Malignant neoplasm of pancreas, unspecified
C48Malignant neoplasm of retroperitoneum and peritoneum
C48.0Malignant neoplasm of retroperitoneum
C48.1Malignant neoplasm of specified parts of peritoneum
C48.2Malignant neoplasm of peritoneum, unspecified
C48.8Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum
C54Malignant neoplasm of corpus uteri
C54.0Malignant neoplasm of isthmus uteri
C54.1Malignant neoplasm of endometrium
C54.2Malignant neoplasm of myometrium
C54.3Malignant neoplasm of fundus uteri
C54.9Malignant neoplasm of corpus uteri, unspecified
C56Malignant neoplasm of ovary
C56.1Malignant neoplasm of right ovary
C56.2Malignant neoplasm of left ovary
C56.9Malignant neoplasm of unspecified ovary
C57Malignant neoplasm of other and unspecified female genital organs
C57.00Malignant neoplasm of unspecified fallopian tube
C57.01Malignant neoplasm of right fallopian tube
C57.02Malignant neoplasm of left fallopian tube
C78Secondary malignant neoplasm of respiratory and digestive organs
C78.0Secondary malignant neoplasm of lung
C78.00Secondary malignant neoplasm of unspecified lung
C78.2Secondary malignant neoplasm of pleura
C78.4Secondary malignant neoplasm of small intestine
C78.89Secondary malignant neoplasm of other digestive organs
C79Secondary malignant neoplasm of other and unspecified sites
C79.00Secondary malignant neoplasm of unspecified kidney and renal pelvis
C79.11Secondary malignant neoplasm of bladder
C79.2Secondary malignant neoplasm of skin
C79.31Secondary malignant neoplasm of brain
C79.49Secondary malignant neoplasm of other parts of nervous system
C79.51Secondary malignant neoplasm of bone
C79.52Secondary malignant neoplasm of bone marrow
C79.6Secondary malignant neoplasm of ovary
C79.7Secondary malignant neoplasm of adrenal gland
C79.81Secondary malignant neoplasm of breast
C79.82Secondary malignant neoplasm of genital organs
C79.89Secondary malignant neoplasm of other specified sites
C79.9Secondary malignant neoplasm of unspecified site
C80Malignant neoplasm without specification of site
C80.0Disseminated malignant neoplasm, unspecified
C80.1Malignant (primary) neoplasm, unspecified
C80.2Malignant neoplasm associated with transplanted organ
D21Other benign neoplasms of connective and other soft tissue
D27Benign neoplasm of ovary
D27.0Benign neoplasm of right ovary
D27.1Benign neoplasm of left ovary
D27.9Benign neoplasm of unspecified ovary
E00Congenital iodine-deficiency syndrome
E02Subclinical iodine-deficiency hypothyroidism
E03Other hypothyroidism
E03.8Other specified hypothyroidism
E03.9Hypothyroidism, unspecified
E89.0Postprocedural hypothyroidism
N80Endometriosis
N80.0Endometriosis of uterus
N80.9Endometriosis, unspecified
N85Other noninflammatory disorders of uterus, except cervix
N85.02Endometrial intraepithelial neoplasia [EIN]
R97Abnormal tumor markers
R97.0Elevated carcinoembryonic antigen [CEA]
R97.1Elevated cancer antigen 125 [CA 125]
Z12.73Encounter for screening for malignant neoplasm of ovary
Z12.8Encounter for screening for malignant neoplasm of other sites
Z12.89Encounter for screening for malignant neoplasm of other sites
Z51.1Encounter for antineoplastic chemotherapy and immunotherapy
Z85Personal history of malignant neoplasm
Z85.07Personal history of malignant neoplasm of pancreas
Z85.42Personal history of malignant neoplasm of other parts of uterus
Z85.43Personal history of malignant neoplasm of ovary
Z85.44Personal history of malignant neoplasm of other female genital organs

Additional ICD10
C25.0Malignant neoplasm of head of pancreas
C25.1Malignant neoplasm of body of pancreas
C25.2Malignant neoplasm of tail of pancreas
C25.3Malignant neoplasm of pancreatic duct
C25.4Malignant neoplasm of endocrine pancreas
C25.7Malignant neoplasm of other parts of pancreas
C25.8Malignant neoplasm of overlapping sites of pancreas
C25.9Malignant neoplasm of pancreas, unspecified
C48.0Malignant neoplasm of retroperitoneum
C48.1Malignant neoplasm of specified parts of peritoneum
C48.2Malignant neoplasm of peritoneum, unspecified
C48.8Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum
C54.0Malignant neoplasm of isthmus uteri
C54.1Malignant neoplasm of endometrium
C54.2Malignant neoplasm of myometrium
C54.3Malignant neoplasm of fundus uteri
C54.8Malignant neoplasm of overlapping sites of corpus uteri
C54.9Malignant neoplasm of corpus uteri, unspecified
C56.1Malignant neoplasm of right ovary
C56.2Malignant neoplasm of left ovary
C56.9Malignant neoplasm of unspecified ovary
C57.0Malignant neoplasm of fallopian tube
C57.00Malignant neoplasm of unspecified fallopian tube
C57.01Malignant neoplasm of right fallopian tube
C57.02Malignant neoplasm of left fallopian tube
C57.1Malignant neoplasm of broad ligament
C57.10Malignant neoplasm of unspecified broad ligament
C57.11Malignant neoplasm of right broad ligament
C57.12Malignant neoplasm of left broad ligament
C57.2Malignant neoplasm of round ligament
C57.20Malignant neoplasm of unspecified round ligament
C57.21Malignant neoplasm of right round ligament
C57.22Malignant neoplasm of left round ligament
C57.3Malignant neoplasm of parametrium
C57.4Malignant neoplasm of uterine adnexa, unspecified
C57.7Malignant neoplasm of other specified female genital organs
C57.8Malignant neoplasm of overlapping sites of female genital organs
C57.9Malignant neoplasm of female genital organ, unspecified
C78.0Secondary malignant neoplasm of lung
C78.00Secondary malignant neoplasm of unspecified lung
C78.01Secondary malignant neoplasm of right lung
C78.02Secondary malignant neoplasm of left lung
C78.1Secondary malignant neoplasm of mediastinum
C78.2Secondary malignant neoplasm of pleura
C78.3Secondary malignant neoplasm of other and unspecified respiratory organs
C78.30Secondary malignant neoplasm of unspecified respiratory organ
C78.39Secondary malignant neoplasm of other respiratory organs
C78.4Secondary malignant neoplasm of small intestine
C78.5Secondary malignant neoplasm of large intestine and rectum
C78.6Secondary malignant neoplasm of retroperitoneum and peritoneum
C78.7Secondary malignant neoplasm of liver and intrahepatic bile duct
C78.8Secondary malignant neoplasm of other and unspecified digestive organs
C78.80Secondary malignant neoplasm of unspecified digestive organ
C78.89Secondary malignant neoplasm of other digestive organs
C79.0Secondary malignant neoplasm of kidney and renal pelvis
C79.00Secondary malignant neoplasm of unspecified kidney and renal pelvis
C79.01Secondary malignant neoplasm of right kidney and renal pelvis
C79.02Secondary malignant neoplasm of left kidney and renal pelvis
C79.1Secondary malignant neoplasm of bladder and other and unspecified urinary organs
C79.10Secondary malignant neoplasm of unspecified urinary organs
C79.11Secondary malignant neoplasm of bladder
C79.19Secondary malignant neoplasm of other urinary organs
C79.2Secondary malignant neoplasm of skin
C79.3Secondary malignant neoplasm of brain and cerebral meninges
C79.31Secondary malignant neoplasm of brain
C79.32Secondary malignant neoplasm of cerebral meninges
C79.4Secondary malignant neoplasm of other and unspecified parts of nervous system
C79.40Secondary malignant neoplasm of unspecified part of nervous system
C79.49Secondary malignant neoplasm of other parts of nervous system
C79.5Secondary malignant neoplasm of bone and bone marrow
C79.51Secondary malignant neoplasm of bone
C79.52Secondary malignant neoplasm of bone marrow
C79.6Secondary malignant neoplasm of ovary
C79.60Secondary malignant neoplasm of unspecified ovary
C79.61Secondary malignant neoplasm of right ovary
C79.62Secondary malignant neoplasm of left ovary
C79.7Secondary malignant neoplasm of adrenal gland
C79.70Secondary malignant neoplasm of unspecified adrenal gland
C79.71Secondary malignant neoplasm of right adrenal gland
C79.72Secondary malignant neoplasm of left adrenal gland
C79.8Secondary malignant neoplasm of other specified sites
C79.81Secondary malignant neoplasm of breast
C79.82Secondary malignant neoplasm of genital organs
C79.89Secondary malignant neoplasm of other specified sites
C79.9Secondary malignant neoplasm of unspecified site
C80.0Disseminated malignant neoplasm, unspecified
C80.1Malignant (primary) neoplasm, unspecified
C80.2Malignant neoplasm associated with transplanted organ
D13.6Benign neoplasm of pancreas
D21.0Benign neoplasm of connective and other soft tissue of head, face and neck
D21.1Benign neoplasm of connective and other soft tissue of upper limb, including shoulder
D21.10Benign neoplasm of connective and other soft tissue of unspecified upper limb, including shoulder
D21.11Benign neoplasm of connective and other soft tissue of right upper limb, including shoulder
D21.12Benign neoplasm of connective and other soft tissue of left upper limb, including shoulder
D21.2Benign neoplasm of connective and other soft tissue of lower limb, including hip
D21.20Benign neoplasm of connective and other soft tissue of unspecified lower limb, including hip
D21.21Benign neoplasm of connective and other soft tissue of right lower limb, including hip
D21.22Benign neoplasm of connective and other soft tissue of left lower limb, including hip
D21.3Benign neoplasm of connective and other soft tissue of thorax
D21.4Benign neoplasm of connective and other soft tissue of abdomen
D21.5Benign neoplasm of connective and other soft tissue of pelvis
D21.6Benign neoplasm of connective and other soft tissue of trunk, unspecified
D21.9Benign neoplasm of connective and other soft tissue, unspecified
D27.0Benign neoplasm of right ovary
D27.1Benign neoplasm of left ovary
D27.9Benign neoplasm of unspecified ovary
D39.1Neoplasm of uncertain behavior of ovary
D39.10Neoplasm of uncertain behavior of unspecified ovary
D39.11Neoplasm of uncertain behavior of right ovary
D39.12Neoplasm of uncertain behavior of left ovary
D61.810Antineoplastic chemotherapy induced pancytopenia
D64.81Anemia due to antineoplastic chemotherapy
D70.1Agranulocytosis secondary to cancer chemotherapy
E00.0Congenital iodine-deficiency syndrome, neurological type
E00.1Congenital iodine-deficiency syndrome, myxedematous type
E00.2Congenital iodine-deficiency syndrome, mixed type
E00.9Congenital iodine-deficiency syndrome, unspecified
E03.0Congenital hypothyroidism with diffuse goiter
E03.1Congenital hypothyroidism without goiter
E03.2Hypothyroidism due to medicaments and other exogenous substances
E03.3Postinfectious hypothyroidism
E03.4Atrophy of thyroid (acquired)
E03.5Myxedema coma
E03.8Other specified hypothyroidism
E03.9Hypothyroidism, unspecified
N80.0Endometriosis of uterus
N80.1Endometriosis of ovary
N80.2Endometriosis of fallopian tube
N80.3Endometriosis of pelvic peritoneum
N80.4Endometriosis of rectovaginal septum and vagina
N80.5Endometriosis of intestine
N80.6Endometriosis in cutaneous scar
N80.8Other endometriosis
N80.9Endometriosis, unspecified
N85.0Endometrial hyperplasia
N85.00Endometrial hyperplasia, unspecified
N85.01Benign endometrial hyperplasia
N85.02Endometrial intraepithelial neoplasia [EIN]
N85.2Hypertrophy of uterus
N85.3Subinvolution of uterus
N85.4Malposition of uterus
N85.5Inversion of uterus
N85.6Intrauterine synechiae
N85.7Hematometra
N85.8Other specified noninflammatory disorders of uterus
N85.9Noninflammatory disorder of uterus, unspecified
P04.11Newborn affected by maternal antineoplastic chemotherapy
R97.0Elevated carcinoembryonic antigen [CEA]
R97.1Elevated cancer antigen 125 [CA 125]
R97.2Elevated prostate specific antigen [PSA]
R97.20Elevated prostate specific antigen [PSA]
R97.21Rising PSA following treatment for malignant neoplasm of prostate
R97.8Other abnormal tumor markers
T80.810Extravasation of vesicant antineoplastic chemotherapy
T80.810AExtravasation of vesicant antineoplastic chemotherapy, initial encounter
T80.810DExtravasation of vesicant antineoplastic chemotherapy, subsequent encounter
T80.810SExtravasation of vesicant antineoplastic chemotherapy, sequela
Z12.73Encounter for screening for malignant neoplasm of ovary
Z15.02Genetic susceptibility to malignant neoplasm of ovary
Z51.1Encounter for antineoplastic chemotherapy and immunotherapy
Z51.11Encounter for antineoplastic chemotherapy
Z80.41Family history of malignant neoplasm of ovary
Z85.0Personal history of malignant neoplasm of digestive organs
Z85.00Personal history of malignant neoplasm of unspecified digestive organ
Z85.01Personal history of malignant neoplasm of esophagus
Z85.02Personal history of malignant neoplasm of stomach
Z85.020Personal history of malignant carcinoid tumor of stomach
Z85.028Personal history of other malignant neoplasm of stomach
Z85.03Personal history of malignant neoplasm of large intestine
Z85.030Personal history of malignant carcinoid tumor of large intestine
Z85.038Personal history of other malignant neoplasm of large intestine
Z85.04Personal history of malignant neoplasm of rectum, rectosigmoid junction, and anus
Z85.040Personal history of malignant carcinoid tumor of rectum
Z85.048Personal history of other malignant neoplasm of rectum, rectosigmoid junction, and anus
Z85.05Personal history of malignant neoplasm of liver
Z85.06Personal history of malignant neoplasm of small intestine
Z85.060Personal history of malignant carcinoid tumor of small intestine
Z85.068Personal history of other malignant neoplasm of small intestine
Z85.07Personal history of malignant neoplasm of pancreas
Z85.09Personal history of malignant neoplasm of other digestive organs
Z85.1Personal history of malignant neoplasm of trachea, bronchus and lung
Z85.11Personal history of malignant neoplasm of bronchus and lung
Z85.110Personal history of malignant carcinoid tumor of bronchus and lung
Z85.118Personal history of other malignant neoplasm of bronchus and lung
Z85.12Personal history of malignant neoplasm of trachea
Z85.2Personal history of malignant neoplasm of other respiratory and intrathoracic organs
Z85.20Personal history of malignant neoplasm of unspecified respiratory organ
Z85.21Personal history of malignant neoplasm of larynx
Z85.22Personal history of malignant neoplasm of nasal cavities, middle ear, and accessory sinuses
Z85.23Personal history of malignant neoplasm of thymus
Z85.230Personal history of malignant carcinoid tumor of thymus
Z85.238Personal history of other malignant neoplasm of thymus
Z85.29Personal history of malignant neoplasm of other respiratory and intrathoracic organs
Z85.3Personal history of malignant neoplasm of breast
Z85.4Personal history of malignant neoplasm of genital organs
Z85.40Personal history of malignant neoplasm of unspecified female genital organ
Z85.41Personal history of malignant neoplasm of cervix uteri
Z85.42Personal history of malignant neoplasm of other parts of uterus
Z85.43Personal history of malignant neoplasm of ovary
Z85.44Personal history of malignant neoplasm of other female genital organs
Z85.45Personal history of malignant neoplasm of unspecified male genital organ
Z85.46Personal history of malignant neoplasm of prostate
Z85.47Personal history of malignant neoplasm of testis
Z85.48Personal history of malignant neoplasm of epididymis
Z85.49Personal history of malignant neoplasm of other male genital organs
Z85.5Personal history of malignant neoplasm of urinary tract
Z85.50Personal history of malignant neoplasm of unspecified urinary tract organ
Z85.51Personal history of malignant neoplasm of bladder
Z85.52Personal history of malignant neoplasm of kidney
Z85.520Personal history of malignant carcinoid tumor of kidney
Z85.528Personal history of other malignant neoplasm of kidney
Z85.53Personal history of malignant neoplasm of renal pelvis
Z85.54Personal history of malignant neoplasm of ureter
Z85.59Personal history of malignant neoplasm of other urinary tract organ
Z85.6Personal history of leukemia
Z85.7Personal history of other malignant neoplasms of lymphoid, hematopoietic and related tissues
Z85.71Personal history of Hodgkin lymphoma
Z85.72Personal history of non-Hodgkin lymphomas
Z85.79Personal history of other malignant neoplasms of lymphoid, hematopoietic and related tissues
Z85.8Personal history of malignant neoplasms of other organs and systems
Z85.81Personal history of malignant neoplasm of lip, oral cavity, and pharynx
Z85.810Personal history of malignant neoplasm of tongue
Z85.818Personal history of malignant neoplasm of other sites of lip, oral cavity, and pharynx
Z85.819Personal history of malignant neoplasm of unspecified site of lip, oral cavity, and pharynx
Z85.82Personal history of malignant neoplasm of skin
Z85.820Personal history of malignant melanoma of skin
Z85.821Personal history of Merkel cell carcinoma
Z85.828Personal history of other malignant neoplasm of skin
Z85.83Personal history of malignant neoplasm of bone and soft tissue
Z85.830Personal history of malignant neoplasm of bone
Z85.831Personal history of malignant neoplasm of soft tissue
Z85.84Personal history of malignant neoplasm of eye and nervous tissue
Z85.840Personal history of malignant neoplasm of eye
Z85.841Personal history of malignant neoplasm of brain
Z85.848Personal history of malignant neoplasm of other parts of nervous tissue
Z85.85Personal history of malignant neoplasm of endocrine glands
Z85.850Personal history of malignant neoplasm of thyroid
Z85.858Personal history of malignant neoplasm of other endocrine glands
Z85.89Personal history of malignant neoplasm of other organs and systems
Z85.9Personal history of malignant neoplasm, unspecified
Z92.21Personal history of antineoplastic chemotherapy

References