Which statement best describes limitations of CA-125 as an ovarian cancer screening test?

• A. Elevated in non-malignant conditions and not sensitive or specific for screening; used mainly for monitoring
• B. Elevated only in malignant ovarian tumors
• C. It is highly sensitive and specific for screening asymptomatic women
• D. It is unaffected by liver disease

Answer: (A)

The main concept here is that CA-125 is not a reliable screening test for ovarian cancer because it can be elevated in many non-cancerous conditions and does not have enough sensitivity or specificity for population-wide screening. In practice, CA-125 levels can rise with benign gynecologic issues (like endometriosis or heavy menstruation), liver disease, infections, and other cancers, so a positive result is not specific for ovarian cancer. Early-stage ovarian cancer can also produce normal CA-125 levels, meaning a negative result does not reliably exclude disease, which undermines its usefulness as a screening tool. For these reasons, CA-125 is best used to monitor known disease and assess treatment response or recurrence rather than to screen asymptomatic women. The other statements aren’t correct because CA-125 is not elevated only with malignant tumors, it is not highly sensitive and specific for screening, and it can be influenced by liver disease.