What do we do with all the false-positive CA125s?

Abstract

It is clear from the study by Low et al.1 that there are indeed barriers that prevent women with symptoms associated with ovarian cancer from presenting to GPs. Removing these barriers will lead to a more widespread adoption of the NICE guidance, which in turn will lead to increased use of CA125 in general practice. Although much is known about CA125 and its performance as a biomarker, there are still many unanswered questions regarding its role as a triage tool for women who have a range of relatively nonspecific symptoms. The full impact of the NICE guidance is unclear, but we are concerned that it may identify large numbers of women who have a raised serum CA125 level in the absence of any evidence of other disease. How these women should be managed has not been defined and will need careful thought if we are to avoid generating a cohort of women with high levels of anxiety or who become victims of unnecessary intervention as a result of receiving a false-positive result from a diagnostic test.