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Ovarian Cancer Screening Options and Their Limitations

Posted on April 18, 2022
Medically reviewed by
Howard Goodman, M.D.
Article written by
Anastasia Climan, RDN, CDN

When a doctor diagnoses a person’s cancer in its early stages, they’ll have more treatment options available. Unfortunately, no specific tests can identify early-stage ovarian cancer in the same way mammograms can check for breast cancer or pap smears can spot cervical cancer. These tests are known as screening tools — medical tests that look for conditions before any symptoms have started. Without an effective screening tool, many ovarian cancer cases go under the radar for too long.

Nonetheless, some tests may spot the signs of ovarian cancer before it spreads. Your health care provider can advise you on the right screening tests for you based on your family history and other risk factors.

Here’s an overview of the current tools available for the early detection of ovarian cancer and what you can do if you have an increased risk compared to the general population.

Measuring Your Ovarian Cancer Risk

As important as it is to be proactive about health screenings, undergoing unnecessary tests can be a financial burden and a source of worry. They can also lead to unnecessary interventions, such as in cases when a test wrongly indicates the presence of cancer, called a false positive. That’s why it’s wise to assess your risk before taking further steps to find ovarian cancer. Average-risk people likely won't require the following tests. People at elevated risk, however, may choose to undergo these screenings.

Factors that elevate a person’s risk for ovarian cancer include having a strong family history of ovarian cancer, breast cancer, or related gene mutations (like BRCA1 or BRCA2 gene mutations or those responsible for Lynch syndrome). Your health care provider can help you calculate your risk.

These tests may also be performed if you have symptoms of ovarian cancer that can’t be attributed to another cause. However, they would not be considered screening tests, since symptoms are already present.

Transvaginal Ultrasound

A transvaginal ultrasound (TVUS) is a common method for checking for ovarian cancer. This test entails inserting an ultrasound wand into the vagina to get a picture of the ovaries, fallopian tubes, and uterus.

It’s important to keep in mind that the presence of an ovarian mass (growth or lump) doesn’t mean you have cancer. Wait to discuss your test results with your doctor before jumping to conclusions or becoming alarmed by what appears on the screen.

Learn more about ultrasound images for ovarian cancer and what they mean.

CA-125 Blood Test

A protein in the blood called CA-125 is a tumor marker used during ovarian cancer treatment. When a person has been diagnosed with ovarian cancer, changes in their CA-125 levels can help doctors know if treatment is working. Measuring CA-125 levels can be useful for diagnosing or monitoring ovarian cancer. However, it can’t be used alone to diagnose the condition because CA-125 is a marker for many different conditions, such as endometriosis or pelvic inflammatory disease.

Learn more about the CA-125 blood test for ovarian cancer.

Combining Both Tests

When combined, a TVUS and CA-125 blood test can better identify ovarian cancer than they can individually. The predictive value for an abnormal test result is 1 percent for TVUS and 3.7 percent for CA-125. However, abnormal results from both tests can predict ovarian cancer at a rate of 23.5 percent. If your doctor suspects that you may be at risk for ovarian cancer, using both of these tests will provide a more accurate assessment.

Limitations of Current Screening Options

Cancer research shows that TVUS screenings or CA-125 tests are less effective in reducing ovarian cancer death rates for people who are at average risk for the condition. One reason for this is, that a TVUS can spot a mass on the ovaries — but it can’t distinguish between cancerous tumors and benign (noncancerous) growths.

Some people with ovarian cancer don’t have elevated CA-125 levels. Furthermore, it’s possible to get a false-positive test result when high levels of CA-125 are caused by other conditions.

Although these screenings can be helpful under the right circumstances, they may do more harm than good in people of average risk. Unless you have a genetic predisposition or symptoms of ovarian cancer, it’s best to stick to the recommended screening guidelines and focus on healthy lifestyle habits, such as eating a balanced diet, managing stress, and exercising.

The Process of Elimination

If you visit the doctor with symptoms of ovarian cancer, they can use various tests to rule out other potential causes and pinpoint the right diagnosis. The symptoms of ovarian cancer can include bloating, an urge to urinate, fatigue, heartburn, and pain during sex, so there are several possible issues to consider.

For instance, symptoms such as constipation, bloating, and heartburn could be caused by an underlying digestive disorder. Hormonal changes, like perimenopause or menopause, may be to blame for fatigue and painful intercourse.

After interviewing you about your concerns, your doctor can order a series of blood tests — and in some cases, biopsies, or imaging tests — to better understand your health status. Because there’s no surefire screening method for ovarian cancer, checking for other conditions first can uncover the answers you’re looking for.

If you haven’t been diagnosed with another condition but still feel like something isn’t right, it’s crucial to advocate for yourself. Don’t ignore your intuition if you believe your health issues aren’t being addressed. Some of the next steps you can take include keeping a symptom log to share with your doctor or getting a second opinion.

If there’s one regret people with ovarian cancer often note, it’s that they wish they’d pushed harder for early detection. Looking beyond your initial test results to find the cause of your symptoms is important, especially if they persist or worsen over time.

Other Health Screening Tools

The U.S. National Institute of Health recommends several other health screenings for women, including:

  • Mammograms to screen for breast cancer, generally starting after age 50
  • Pap smears to check for cervical cancer cells every three years beginning at age 21
  • Skin cancer checks, colonoscopies, and bone density screenings
  • Screenings for diabetes, high cholesterol, and high blood pressure

Talk to your health care provider to see which tests are right for you.

Health care screening recommendations can also vary based on where you live. Your health care provider can guide you on the ideal time for preventive screenings and follow-ups based on your family and personal medical history.

It’s worth noting that heart disease is the leading cause of death for women in the United States, accounting for 20 percent of total fatalities. Although cancer screenings are important, healthy habits that protect your heart may have a greater effect on your longevity and quality of life. Not smoking, staying active, and keeping an eye on your blood sugar and blood pressure levels are some of the best ways to maintain good health.

Talk With Others Who Understand

MyOvarianCancerTeam is the social network for people with ovarian cancer and their loved ones. On MyOvarianCancerTeam, more than 4,000 members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.

Did you notice early signs of ovarian cancer? How did you get diagnosed? Share your experience in the comments below, or start a conversation by posting on MyOvarianCancerTeam.

All updates must be accompanied by text or a picture.
Howard Goodman, M.D. is certified by the American Board of Obstetrics and Gynecology and specializes in the surgical management of women with gynecologic cancer. Review provided by VeriMed Healthcare Network.. Learn more about him here.
Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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