The performance of CA-125 measurement in the detection of endometriosis: a meta-analysis
Open accessAbstract
Objective To assess the diagnostic performance of serum CA-125 measurement in the detection of endometriosis.Design Meta-analysis.Setting and patient(s) Twenty-three studies comparing serum CA-125 levels and laparoscopically confirmed endometriosis.Intervention(s) Serum CA-125 measurement and laparoscopy.Main outcome measure(s) Sensitivity and specificity of serum CA-125 measurement in the diagnosis of endometriosis with laparoscopy as the reference standard.Result(s) The estimated summary receiver operating characteristic curves showed that the performance of serum CA-125 measurement in the diagnosis of endometriosis grade I/IV is limited, whereas its performance in the diagnosis of endometriosis grade III/IV is better.Conclusion(s) Despite its limited diagnostic performance, we believe that the routine use of serum CA-125 measurement in patients with infertility might be justified. In contrast to laparoscopy, serum CA-125 measurement is an inexpensive test that is not a burden for the patient. It could identify a subgroup of patients who are more likely to benefit from early laparoscopy. Studies reporting on the mutual dependence between serum CA-125 measurement and data from the history and physical examination are needed.
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The sensitivity of CA-125 to detect all endometriosis stages is low.
“In addition to this lack of specificity, the sensitivity to detect all endometriosis stages is low [31].”
From Update on biomarkers for the detection of endometriosis (2015) · cites this paper as [31]
According to a meta-analysis by Mol et al., CA-125 sensitivity for stage I-IV endometriosis was 50% and specificity was 72%.
“According to a meta-analysis by Mol et al., the sensitivity for stage I–IV endometriosis was 50% and specificity was 72%.”
From Update on biomarkers for the detection of endometriosis (2015) · cites this paper as [31]
For stage III-IV endometriosis, CA-125 sensitivity of 60% could be obtained with specificity of 80%.
“For stage III-IV endometriosis, a sensitivity of 60% could be obtained with a specificity of 80% [31].”
From Update on biomarkers for the detection of endometriosis (2015) · cites this paper as [31]
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References 53 · Cited by 355
- Authors
- Mol, B. W. J., Bayram, N., Lijmer, J. G., Wiegerinck, M. A. H. M., Bongers, M. Y., van der Veen, F., & Bossuyt, P. M. M.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Mol, Ben W.J
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1998-12
- Volume
- 70
- Issue
- 6
- Pages
- 1101-1108
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2110530600
- Cited by
- 355
- References
- 53
- Citations by year
- 2026: 12 · 2025: 7 · 2024: 9 · 2023: 14 · 2022: 23 · 2021: 12 · 2020: 9 · 2019: 18 · 2018: 20 · 2017: 13 · 2016: 12 · 2015: 27 · 2014: 22 · 2013: 19 · 2012: 18
- FWCI
- 1.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- CA125, endometriosis, serum biomarkers, diagnostic accuracy, sensitivity and specificity, infertility, laparoscopy, early diagnosis
- MeSH terms
- Endometriosis, Female, Humans, Laparoscopy, Predictive Value of Tests, Reference Standards, ROC Curve, Sensitivity and Specificity, CA-125 Antigen
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