Early detection of ovarian cancer

Each year about 1400 women in Australia are diagnosed with ovarian cancer. The main risk factor for ovarian cancer is getting older. It is most commonly diagnosed in women who are over 50 years of age. 

Ovarian cancer can be difficult to diagnose at an early stage, largely because symptoms can be vague and similar to those of other common illnesses.

Is there a screening test for ovarian cancer?

Currently there are no tests effective enough for a population-based screening program for ovarian cancer.

In addition, there is no evidence to suggest that screening will reduce the number of deaths from ovarian cancer.

What about the blood test CA125?

The blood test CA125 can be used to help diagnose or exclude ovarian cancer. CA125 is a protein found in the blood and can be produced by ovarian cancer cells.

However, there are other causes for raised CA125 levels such as menstruation, endometriosis or ovarian cysts.

Half of all women with early stage ovarian cancer do not have elevated CA125 levels. The CA125 test is more reliable in postmenopausal women. It is for these reasons CA125 is not recommended as a screening test for women with no symptoms.

For those women with symptoms, the CA125 test alone cannot be used to investigate the symptoms. Transvaginal ultrasound should be used in conjunction with the CA125 test to diagnose ovarian cancer.

What is surveillance?

Surveillance means monitoring women who currently have no symptoms of ovarian cancer, but who are at an increased risk of developing the disease due to family history.

What if I have a family history of ovarian cancer?

Having a genetic family history of ovarian cancer is an important risk factor in developing the disease. A family history of breast cancer and/or bowel cancer is also a risk factor. However, only 5-10% of all ovarian cancers are associated with a family history. The risk of developing ovarian cancer increases with the number of affected first degree relatives (parents, siblings, children).

For an Ashkenazi Jewish woman with a family history of breast or ovarian cancer, Jewish background should be considered as an additional risk factor. If you have a family history of ovarian or breast cancer, talk to your doctor.

What sort of monitoring is available if I have an increased risk?

Currently, there is no evidence that monitoring or screening leads to reduced mortality from ovarian cancer in women at increased risk. This is because there is currently no effective test for the early detection of ovarian cancer.

If you have a family history of ovarian cancer, you should talk to your doctor about options for managing your risk and your concerns.

What are the ovarian cancer symptoms I need to look out for?

Symptoms that may indicate ovarian cancer are vague. It may include one or more of the following:

• abdominal bloating 
• difficulty eating or feeling full quickly
• frequent or urgent urination
• back, abdominal or pelvic pain
• constipation
• menstrual irregularities 
• fatigue
• indigestion
• pain during sexual intercourse.

These symptoms are often related to more common, less serious health problems and most women will have these symptoms at some time. However, if you notice any unusual changes or these symptoms persist, visit your doctor.

Remember, if you have any concerns or questions, please contact your doctor.