A Pap test, or Pap smear, is a test in which a doctor or gynecologist swabs a person’s cervix (the opening of the uterus) to collect cervical cells. The cells are sent to a lab, where they are viewed under a microscope to check for cervical cancer — but not ovarian cancer. In fact, there is currently no preventive screening test for ovarian cancer. Although Pap smears can detect abnormal cells on the cervix, the tests don’t provide any insight into ovarian health.

Learning to detect any unusual symptoms and seeking recommended tests will give you the best chance of early detection before ovarian cancer reaches a more advanced stage.

Why Doesn’t a Pap Smear Detect Ovarian Cancer?

To understand why Pap smears don’t detect ovarian cancer, it’s helpful to understand the basic anatomy of the female reproductive organs, which include the cervix, uterus, fallopian tubes, and ovaries.

The cervix is like a gateway between the vaginal canal and the uterine cavity. The cervix can be described as the top of the vagina or the bottom of the uterus because it connects these two organs together. The cervix is made of fibrous tissue in the shape of a cylinder that’s about 1.6 inches long.

Beyond the cervix is the uterus. Also known as the womb, the uterus is where babies grow during pregnancy. One fallopian tube branches out from each side of the uterus (like arms). A grape-shaped organ hangs off the end of each fallopian tube (like tiny fists) — these organs are the ovaries.

During a Pap test, a doctor uses a medical device called a speculum to widen the vaginal opening. This way, the doctor can view the cervix and collect cells from it and the surrounding area to be examined in the lab. These cervical cells can be tested for precancerous changes and the presence of human papillomavirus (HPV), which can lead to cervical cancer.

Although Pap smears are highly effective at finding cervical cancer in its early stages, the tests don’t play a role in diagnosing ovarian cancer. Because the ovaries sit deep within the body, Pap smears don’t reach ovarian tissue for testing. As a result, ovarian cancer can be difficult to detect.

Watching for Symptoms of Ovarian Cancer

A common symptom of ovarian cancer is the urgent and frequent need to urinate. This is because the ovaries are located next to the bladder, and tumors may press on the bladder. You also may feel full quickly when eating if ovarian tumors increase pressure in the abdomen. Ovarian cancer is linked to digestive issues like diarrhea, constipation, bloating, and nausea.

The symptoms of ovarian cancer may overlap with other issues or go undetected. As a result, 4 out of 5 women with symptoms will be misdiagnosed. About 25 percent of women with ovarian cancer wait for six months or more for an accurate diagnosis.

Ovarian Cancer Diagnosis

Although there are challenges in preventive screening, newer tests can help you find answers if you suspect you are at risk of cancer or are experiencing the symptoms of ovarian cancer. These tests include:

• A bimanual exam (also called a vaginal-rectal pelvic exam) to check the ovaries
• A CA-125 blood test to measure a protein associated with ovarian cancer
• A transvaginal ultrasound to help spot physical changes to the ovaries

You may also consider genetic testing to look for gene mutations on the BRCA1, BRCA2, and related genes. These genes are associated with a higher risk of ovarian cancer.

The majority of people with symptoms of ovarian cancer don’t end up having ovarian cancer. Although you should always follow up with your gynecologist if you think something is wrong, you may not benefit from unnecessary testing for ovarian cancer. Review your risk factors, family history, and symptoms with your health care professional to determine the most appropriate ways to protect your health.

Talk With Others Who Understand

MyOvarianCancerTeam is the social network for people with ovarian cancer and their loved ones. On MyOvarianCancerTeam, more than 3,400 members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.

Are you living with ovarian cancer? What symptoms have you experienced, and how did testing lead to your diagnosis? Share your experience in the comments below, or start a conversation by posting on MyOvarianCancerTeam.