Quick Facts
- Sample: Blood draw (1 mL serum)
- Fasting: Not required
- Turn-around: 4-7 days. May take longer based on weather, holiday, or lab delays.
Benefits
- Superior accuracy with 90-97% specificity for ovarian cancer detection
- Convenient monitoring without physician referrals or lengthy appointments
- Cost-effective testing at $169-299, significantly lower than hospital pricing
- Confidential results delivered securely online within days
- Advanced biomarker using electrochemiluminescence immunoassay technology
- Complementary testing works with CA125 for enhanced diagnostic accuracy
Who Is This Test For?
- Women diagnosed with epithelial ovarian cancer requiring treatment monitoring
- Patients with elevated HE4 levels before treatment needing baseline establishment
- Individuals where CA125 testing alone provides insufficient information
- Women with family history seeking proactive gynecologic cancer surveillance
- Patients participating in ROMA algorithm risk assessment protocols
How It Works – Just 3 Steps
- Schedule your appointment at any walk-in lab location near you
- Simple blood draw performed by certified phlebotomist (no fasting required)
- Receive results securely online within 4-7 days
FAQ
What does HE4 measure?
HE4 measures a protein primarily produced by epithelial ovarian cancer cells, serving as a tumor biomarker for monitoring treatment response and disease progression.
Is HE4 better than CA125?
HE4 offers superior specificity (97% vs 67%) while CA125 has higher sensitivity; combined testing provides the most accurate results.
Can this test detect early ovarian cancer?
HE4 is FDA-approved for monitoring treated ovarian cancer, not for screening asymptomatic women or early detection purposes.
How accurate is the HE4 test? Studies show HE4 demonstrates 77-85% sensitivity and 90-97% specificity for ovarian cancer detection with excellent reliability.
What affects HE4 levels? Smoking, kidney disease, and endometriosis can elevate HE4 levels; results must be interpreted with clinical findings and patient history.
Do I need a doctor's order? No physician referral required; you can order directly through walk-in lab platforms for convenient, confidential testing.
More Details
What is the purpose of this test?
The HE4 blood test monitors epithelial ovarian cancer treatment response and detects disease recurrence or progression (Mayo Clinic 2025). This sophisticated tumor biomarker measures serum levels of Human Epididymis Protein 4, a glycoprotein primarily produced by epithelial ovarian cancer cells. Unlike traditional screening tests, HE4 demonstrates superior specificity compared to CA125, particularly in distinguishing malignant from benign ovarian conditions (International Journal of Pharmaceutical and Clinical Research 2024). The test is FDA-approved specifically for monitoring recurrence or progressive disease in patients with treated epithelial ovarian cancer.
Who would benefit from this test?
Women with diagnosed epithelial ovarian cancer requiring treatment monitoring benefit most from HE4 testing. Patients with elevated pre-treatment HE4 levels can establish baselines for future comparison. Those where CA125 alone provides insufficient monitoring information also find HE4 valuable (ARUP Laboratories 2025). High-risk individuals with family history or genetic predisposition may use HE4 for proactive health management. The test particularly helps patients participating in ROMA algorithm assessments combining HE4 and CA125 for enhanced ovarian cancer risk evaluation.
When should I order HE4 testing?
Order HE4 testing before starting ovarian cancer therapy to establish baseline levels, then at regular intervals post-treatment as determined by oncologist recommendations (Mayo Clinic 2025). Patients with previously elevated HE4 levels should test periodically during and after treatment. Consider testing when CA125 results are inconclusive or when participating in comprehensive ovarian cancer monitoring protocols. The test timing should align with clinical follow-up schedules and treatment milestones for optimal cancer surveillance.
How do I interpret the results?
HE4 Level < 140 pmol/L (general):
- What it means: Normal range
- Typical action: Continue routine monitoring
HE4 Level < 73 pmol/L (premenopausal):
- What it means: Normal for premenopausal women
- Typical action: Regular follow-up as scheduled
HE4 Level < 93 pmol/L (postmenopausal):
- What it means: Normal for postmenopausal women
- Typical action: Maintain surveillance schedule
HE4 Level ≥ 20% increase:
- What it means: Suggests disease progression
- Typical action: Consult oncologist immediately
HE4 Level ≥ 20% decrease:
- What it means: Indicates treatment response
- Typical action: Continue current therapy
HE4 levels may be elevated in benign conditions including endometriosis, kidney disease, and smoking.
Disclaimer: Reference ranges may vary by laboratory. Listed ranges are general guidelines and may differ from those used by the performing lab. Always consult your healthcare provider for interpretation.
Pre-test preparation
Avoid multivitamins or supplements containing biotin (vitamin B7) for 12 hours before specimen collection (Memorial Healthcare 2025). No fasting is required for HE4 testing. Continue all medications unless specifically advised otherwise by your healthcare provider. The test can be performed at any time of day, and menstrual cycle does not affect results. Smoking significantly elevates HE4 levels, so inform your provider of smoking status for accurate interpretation.
How often should I get tested?
- Active cancer treatment: Every 2–3 months
- Post-treatment monitoring: Every 3–6 months
- Long-term surveillance: Every 6–12 months
- High-risk individuals: Annually or as advised
- Stable remission: Per oncologist guidance
Why early detection matters
Ovarian cancer affects approximately 20,890 women annually in the US, with a lifetime risk of 1 in 91 women (American Cancer Society 2025). Early-stage ovarian cancer (Stage I) has a 90% five-year survival rate versus 30-40% for advanced stages. Only 25% of ovarian cancers are currently diagnosed at early stages, making effective monitoring crucial for survival outcomes. Regular HE4 testing enables timely detection of cancer recurrence, allowing for prompt treatment adjustments and improved patient outcomes.
Related tests you may consider
Carcinoembryonic Antigen (CEA) Blood Test - measures CEA levels, which can be elevated in certain cancers and some non-cancerous conditions, helping doctors monitor cancer treatment, check for recurrence, and assess potential health concerns.
Estradiol (E2) Blood Test, Sensitive, LC/MS-MS - helps determine the causes of infertility, specifically in situations where low estradiol levels are suspected.
Cancer Antigen (CA) 125 Serum Test- Screens for high levels of a protein in the blood to help doctors detect ovarian cancer, monitor how well treatment is working, and see if the cancer comes back.
