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Screening and Detection

No screening test exists for ovarian cancer. The Pap test does not test for ovarian cancer; it screens for cervical cancer. But we do know that early detection of ovarian cancer saves women’s lives!

Let's talk about the terms screening, early detection, and symptom awareness. It's important to know the difference. 

Screening is a procedure done in the general population, like a colonoscopy or Pap smear, that looks for pre-cancerous cells, cysts or lesions. Screening looks for irregularities before cancer has a chance to grow, in order to prevent disease. Again, no screening test exists for ovarian cancer. 

Early detection, on the other hand, is a method of finding cancer in its earliest stages, when intervention can be successful and may help prevent mortality. 

While there is no early detection tool for ovarian cancer, several tests exist for women who are at high risk. If a woman has ovarian cancer symptoms, a strong family history, or a genetic predisposition such as a BRCA mutation, doctors may monitor her with one of three tests or a combination of them:

  • Transvaginal Ultrasound
  • Pelvic / Rectal Examination
  • CA125 Blood Test

Symptom awareness. There is tremendous effort within the ovarian cancer community to share information about signs and symptoms, which are often confused with other conditions. It is important that individuals and healthcare providers are aware of these symptoms, because knowing them can aid in getting an earlier diagnosis and perhaps make treatment a bit easier. Also, correctly identifying symptoms may help patients have time to seek care from a gynecologic oncologist. Studies have shown that ovarian cancer patients treated by gynecologic oncologists have better outcomes. 

Source: Ovarian Cancer Research Alliance

CA 125 Blood Test

  • The protein CA-125 exists in greater concentration in cancerous cells. Though a high count of this protein may help doctors identify ovarian cancer, premenopausal women may have an elevated CA-125 due to benign conditions unrelated to ovarian cancer. Uterine fibroids, liver disease, inflammation of the fallopian tubes, and other types of cancer can raise a woman’s CA-125 level, often causing a false positive test for ovarian cancer.

  • Although the CA-125 blood test is more accurate in postmenopausal women, it is not a reliable early detection test for ovarian cancer. In about 20 percent of advanced stage ovarian cancer cases and 50 percent of early stage cases, the CA-125 is not elevated even though ovarian cancer is present. As a result, doctors generally use the CA-125 blood test in combination with a transvaginal ultrasound.

  • The CA-125 blood test can be an important tool for evaluating the disease’s progress and tumors’ response to treatment. Additionally, this test can monitor a woman’s CA-125 level for evidence of recurrence.

  • OVA1 has also been approved by the Food and Drug Administration (FDA) for risk stratification.  A woman who presents with a known tumor may have this test to determine if her surgery should be done by a gynecologist or a gynecologic oncologist – doctors who are specially trained to treat women with gynecologic cancers.

How is the CA-125 blood test used to detect ovarian cancer?

CA-125 is a biomarker, a protein called Cancer Antigen 125, that may be elevated in the blood of those with ovarian cancer. As a tool for ovarian cancer detection (or screening), it is not perfect – CA-125 is also often elevated in the blood of people with endometriosis, fibroids, liver cirrhosis, and who are pregnant (just to name a few conditions). Furthermore, it misses about half of actual ovarian cancer cases, and therefore ovarian cancer screening guidelines do not recommend the CA-125 blood test as a screening tool in the general population. When doctors suspect ovarian cancer, they may measure CA-125 levels in their patients, but the test is FDA approved for assessing treatment effectiveness after diagnosis, as well as monitoring for recurrence. Learn more about the CA-125 blood test.

What is the harm in screening the general population with a CA-125 blood test?

The only way to definitively diagnose ovarian cancer is through surgery. And since CA-125 levels are often elevated for any number of reasons, using that blood test as a screening tool would send otherwise healthy people into unnecessary surgery. In fact, this could cause more harm (both emotional and physical) to more people than it would save lives, as the exploratory surgery itself comes with risk.

Transvaginal Ultrasound

  • A transvaginal ultrasound is a test used to examine a woman’s reproductive organs and bladder.

  • To administer this painless test, the radiologist inserts a probe into the woman’s vagina. The probe sends off sound waves which reflect off body structures. The waves are then received by a computer that turns them into a picture.

Pelvic Exam

  • A pelvic exam should be a part of a woman’s regular female health exam. This exam requires the doctor to place one or two fingers into a woman’s vagina and another over her abdomen to feel the size, shape, and position of the ovaries and uterus.

  • A pelvic / rectal exam can be a helpful tool if a woman is exhibiting symptoms of ovarian cancer. This quick and simple exam is similar to a pelvic exam but the doctor simultaneously inserts two fingers in the rectum. It allows the doctor to get closer to feeling the ovaries and pelvic wall.

Diagnosis and Staging

If a woman has the signs and symptoms of ovarian cancer, her doctor will probably perform a complete pelvic exam, a transvaginal or pelvic ultrasound, and a CA-125 blood test. Used individually, these tests are not definitive; they are most effective when used in combination with each other. Doctors may also use a CT scan or PET scan as part of the diagnostic process. The only definitive way to determine if a patient has ovarian cancer is through surgery and biopsy.

Source: Ovarian Cancer Research Alliance


Gynecologic Oncologists

Multiple studies conducted over the past decade have shown that an ovarian cancer patient’s chance of survival is significantly improved when her surgery is performed by a gynecologic oncologist. One analysis of multiple studies found that women whose surgeries were performed by gynecologic oncologists had a median survival time that was 50 percent greater than women whose surgeries were done by general gynecologists or other surgeons inexperienced in optimal debulking procedures. Sometimes referred to as cytoreductive surgery, debulking involves removal of as much of the tumor as possible.

As part of the debulking procedure, doctors try to stage definitively the disease and identify the optimal treatment for the cancer. Proper staging and optimal debulking translate into improved overall survival for women at any stage of ovarian cancer.

Gynecologic oncologists have greater success in treating ovarian cancer as a result of their tendency to perform more aggressive surgery. Women whose tumors have been reduced to less than one centimeter have a better response to chemotherapy and improved survival rate. Gynecologic oncologists also are more likely to perform the multiple peritoneal and lymph node biopsies necessary to ensure adequate surgical staging.

Source: Ovarian Cancer Research Alliance

Click on link below for a list of the Gynecologic Oncologists in Colorado: