What Blood Test Tests for Ovarian Cancer?

The primary blood test used to test for ovarian cancer is the CA-125 test, often combined with HE4 and the ROMA index for improved accuracy. However, no single blood test can definitively diagnose ovarian cancer; these markers are used alongside imaging and pelvic exams. Today, updated guidelines emphasize using the ROMA algorithm for women with pelvic masses to stratify risk. This guide explains which blood tests are available, their purpose, and how to order them through anylabtests.com.

Understanding Blood Tests for Ovarian Cancer

Ovarian cancer is often called the “silent killer” because symptoms are vague and late-stage diagnosis is common. Blood tests that measure tumor markers help clinicians assess the likelihood of malignancy, monitor treatment response, and detect recurrence. The three most common biomarkers today are CA-125, HE4, and the ROMA index. These tests are not used for routine screening in average-risk women, but they play a critical role in high-risk populations and diagnostic workups.

CA-125: The Classic Tumor Marker

CA-125 (cancer antigen 125) is a protein found on the surface of ovarian cancer cells. Elevated levels can indicate ovarian cancer, but also occur in endometriosis, pregnancy, fibroids, and other benign conditions. Today, CA-125 remains the most widely ordered blood test for ovarian cancer, but its limited specificity means it is rarely used alone. For premenopausal women, the false-positive rate is higher, so results are interpreted with caution.

HE4: A Newer Biomarker

HE4 (human epididymis protein 4) is a more specific marker for epithelial ovarian cancer. It is less affected by benign gynecologic conditions than CA-125, making it especially useful in premenopausal women. HE4 is often paired with CA-125 in the ROMA index to improve diagnostic accuracy. Today, many laboratories include HE4 as a standard component of ovarian cancer blood test panels.

ROMA Index: Combining Markers for Better Accuracy

The Risk of Ovarian Malignancy Algorithm (ROMA) uses CA-125 and HE4 levels along with menopausal status to calculate a risk score. Recent studies confirm that ROMA has higher sensitivity and specificity than either marker alone, particularly for distinguishing benign from malignant pelvic masses. The test is recommended by the American College of Obstetricians and Gynecologists for women with a pelvic mass who are scheduled for surgery.

When Are These Blood Tests Used?

Screening vs. Diagnostic vs. Monitoring

Blood tests for ovarian cancer are not FDA-approved for general screening in asymptomatic women. Instead, they are used in three contexts:

• Diagnostic workup: When a pelvic mass is detected on ultrasound, CA-125, HE4, and ROMA help assess cancer risk before biopsy or surgery.
• Monitoring treatment: After diagnosis, serial CA-125 levels track response to chemotherapy or surgery. A rising level often signals recurrence.
• High-risk surveillance: Women with BRCA mutations or strong family history may have periodic blood tests starting at age 30–35, though transvaginal ultrasound is also used.

Limitations and Accuracy

No blood test is 100% accurate for ovarian cancer. Today, the following limitations are well documented:

• CA-125 has a sensitivity of about 80% for advanced ovarian cancer but only 50–60% for early-stage disease.
• False positives are common due to endometriosis, pelvic inflammatory disease, and even menstruation.
• HE4 is more specific but can be elevated in renal failure and some lung cancers.
• ROMA index reduces false positives but still requires imaging confirmation.

Therefore, these tests are always interpreted in the context of imaging (transvaginal ultrasound or CT) and clinical findings.

How to Order a Blood Test for Ovarian Cancer

anylabtests.com offers convenient, physician-reviewed blood test panels for ovarian cancer screening and monitoring. Our CA-125, HE4, and ROMA index tests can be ordered online without a doctor’s visit, and results are delivered securely in 1–2 days. If you have a family history of ovarian cancer, are postmenopausal with a pelvic mass, or need routine monitoring after treatment, these tests provide crucial insights. Order your test today and take control of your health.

Click here to order your ovarian cancer blood test panel from anylabtests.com and get fast, confidential results.