Many women with ovarian cancer do not develop symptoms until the cancer has spread beyond the ovary. Symptoms of ovarian cancer include swelling of the abdomen or bloating, pelvic pain or pressure, difficulty eating or feeling full, and urinary frequency or urgency. These symptoms are common in women and usually not associated with ovarian cancer. Women who have severe symptoms or a prolonged duration of symptoms are at heightened risk for ovarian cancer. Women who have these symptoms should seek medical care for evaluation.
The two most commonly used screening tests for ovarian cancer are transvaginal ultrasound (TVUS) and the blood test CA-125. These tests are often used to evaluate women who have symptoms that raise concern for ovarian cancer. When used as screening tests to evaluate women without symptoms, these tests have not shown benefit.
TVUS is an ultrasound examination of the ovary. TVUS is used to evaluate the presence of any cystic (fluid filled) or solid masses on the ovary. TVUS may also detect abnormal fluid (ascites) in the abdominal cavity. TVUS cannot distinguish a cancerous from non-cancerous ovarian mass.
CA-125 is a blood test. CA-125 is often secreted into the blood stream by cancers of the ovary. One problem with CA-125 however, is that the test is non-specific and is often elevated in women with a variety of non-cancerous conditions. CA-125 and TVUS are often used in combination to evaluate women with symptoms concerning for ovarian cancer. TVUS and CA-125 may be recommended as screening tests in women at high-risk for the development of ovarian cancer, particularly those women with BRCA mutations.