Skip to main content

Tests & procedures · UK

CA-125 plus ultrasound

How CA-125 and pelvic ultrasound are used together, what the combination can and cannot rule out, and how results are risk-scored.

Key points

  • The combination pairs the CA-125 blood test with transvaginal ultrasound, often summarised as a Risk of Malignancy Index (RMI) that weighs the blood level, ultrasound features and menopausal status.

  • No fasting is needed; a transvaginal scan gives far better ovarian views than an abdominal one and is standard.

  • Both results are typically available within a week, often sooner.

  • A gynaecologist should interpret the pair together, since CA-125 rises with endometriosis, fibroids, infection and menstruation, and falls short as a standalone cancer test.

About this test

Published 2026-09-27 · Next review 2027-09-27

This combination is the standard first-line workup for investigating symptoms, persistent bloating, pelvic pain, a felt mass, and for characterising ovarian cysts, and used that way it performs well. Used as general screening in well women it does not reduce deaths, as major trials have shown. The distinction matters: the same two tests are valuable diagnostics and poor screens, and an honest clinic will say so.

Private gynaecology clinics arrange both within days without referral; NHS pathways run through GP referral with urgency depending on symptoms and findings. Waiting lists for NHS outpatient assessment remain long in much of the UK, and many of these checks are not offered on the NHS at all unless you meet strict criteria. Private clinics can usually see you within days on a self-pay basis, with no GP referral needed in most cases.

Frequently asked

Common questions about CA-125 plus ultrasound.

Quick, plain-English answers to what people ask us most.

  • What is CA-125 plus ultrasound and what does it show?

    CA-125 plus ultrasound is an imaging or diagnostic procedure that allows doctors to look at the relevant part of the body in detail, helping to identify or rule out specific problems. It gives information that usually can't be obtained from a physical examination or blood test alone. The findings are interpreted alongside your symptoms and medical history.

  • Why might a doctor request it?

    It's usually requested to investigate specific symptoms, follow up on a previous finding, or check on a known condition. It may also form part of a wider screening or health assessment package. Your doctor will explain what they're hoping to see or rule out before referring you.

  • Do I need to prepare beforehand?

    Preparation varies — some procedures require fasting, a full or empty bladder, stopping certain medications, or avoiding specific products beforehand, while others need no preparation at all. Because requirements are specific to this exact procedure, always follow the instructions given by the clinic at booking rather than assuming. Arriving properly prepared reduces the chance of the appointment needing to be rescheduled.

  • What happens during the procedure?

    You'll usually be guided through each step by trained staff, and most of these procedures are performed with you either lying still, seated, or in a specific position for a short period. Depending on the exact test, it may take anywhere from a few minutes to around an hour. Staff will explain what to expect and answer any questions before you begin.

  • Is it painful, and are there any risks?

    Many imaging procedures are painless or involve only mild, brief discomfort, though some more invasive tests may involve sedation or a small associated risk that will be explained beforehand. Serious complications are uncommon with modern techniques and experienced practitioners. You'll be given specific information about risks relevant to your particular procedure and health background before you consent.

  • How long does it take to get results?

    Results are typically reviewed by a specialist and reported within a few working days, though timeframes can vary depending on complexity. Some findings may be discussed with you immediately after the procedure, with a full written report to follow. The clinic will confirm the expected timeframe when you book.

  • What happens if something abnormal is found?

    If the results show something unexpected, a specialist will explain what it means and recommend appropriate next steps, which might include further imaging, a biopsy, or referral to a relevant specialist. Many abnormal findings turn out to be minor or unrelated to any symptoms once fully assessed. You'll be talked through the findings rather than left to interpret a report alone.

  • Is this available on the NHS, or is private quicker?

    This type of procedure is generally available on the NHS, but routine referrals can involve a wait for both the appointment and the results. Private providers typically offer appointments within days and results reviewed by a specialist soon after, which can be helpful if you want quicker reassurance or a second opinion. Cost for private testing varies by provider.

  • How accurate is this type of test?

    When performed by trained specialists on appropriate equipment, this is generally considered a reliable and clinically well-established investigation. As with any single test, results are best interpreted alongside your symptoms and other findings rather than in isolation. If a result is unclear or unexpected, further imaging or a repeat test may be recommended.

  • How do I book CA-125 plus ultrasound privately?

    You can usually book directly with a private clinic, often without needing a GP referral, with appointments typically available within a matter of days. It's worth asking about preparation requirements and what the appointment will involve when you book. Contact the clinic for current availability and to discuss any specific concerns.