How concerned should I be if my ca125 level was not ordered this year?

None to minimal. If the ca-125 was going to be used simply as another blood test for example in a yearly physical, you should not be terribly concerned at all. My answer is different however, if you have a history of a disease such as ovarian cancer and that it should be checked. I also might order it if you have a strong family history of ovarian cancer for example. If not you should not be concerned.