Introduction
In the United Kingdom (UK) the first step in the ovarian cancer diagnostic pathway for patients presenting to their General Practitioner (GP) with relevant symptoms is to measure the CA125 in serum[1]. This process has a good positive predictive value to trigger the next investigation, a pelvic ultrasound to identify a lesion. Measuring Human Epididymis Protein 4 (HE4) identifies more accurately those pelvic masses that are malignant[2], although this is not in current routine use in the UK. The role of HE4 as a diagnostic test in primary care has recently been evaluated[3]. HE4 performed well in patients aged under 50. The possibility exists that measuring it alongside CA125 would improve the diagnostic performance of the standard pathway. We sought to relate the HE4 results to clinical status in a group of patients with elevated CA125 from whom clinical information was available.