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Unfortunately, the CA-125 test will become elevated for a variety of reasons that have nothing to do with ovarian cancer. The most common reasons for CA-125 elevation in a random sample of the population include endometriosis, fibroids of the uterus, diverticulosis, and cirrhosis. Because these conditions often cause abdominal crampy pain and bloating, confirming a clinical suspicion of ovarian cancer cannot be done with a CA-125 blood test.
Pregnancy can cause high CA-125, as can menstruation. Elevations of the CA-125 occur in patients with nonspecific inflammatory conditions of the abdominal cavity, including appendicitis, ectopic pregnancy, and trauma (for example, after abdominal surgery for any reason).
In my experience, the highest "false positive" CA-125 levels have been in patients with endometriosis of the ovary or tubes and ovaries that have become infected.
Because CA-125 testing is associated with such a high rate of false positive results, random screening is not recommended. In addition, one must be judicious in interpretation of results. Even if the CA-125 is normal, a woman with other signs and symptoms of ovarian cancer should be referred for surgery to make the diagnosis.
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What conditions other than ovarian cancer can cause an elevated CA-125?