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Early detection of ovarian cancer via ROCA even though CA125 remains below 35 U/mL. The consistent increase in CA125 from the nadir (blue arrow) increases the calculated risk of having ovarian cancer with each additional CA125 test until the risk is elevated (red circles) with a recommendation of a trans-vaginal ultrasound. Surgery was recommended at the second ultrasound and a mixed endometrioid and serous ovarian cancer (stage IIB) detected.
