Screening for Ovarian Cancer

The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.

Screening Tests

Screening tests are designed to find patients with early cancer or those who are high risk. Whenever you go for a screening procedure, be certain to tell your screener if you have any high risk factors, especially a family history.

Pelvic exam—Your annual checkup includes a ]]>Pap smear]]> for ]]>cervical cancer]]> and a pelvic exam for other female disorders, among them ]]>ovarian cancer]]>. If you have a history of ]]>breast cancer]]> or a mother or sister with ovarian cancer, make sure your healthcare provider is aware of your increased risk. If she cannot do a satisfactory pelvic exam (because of your weight, your anatomy, or the discomfort it causes), an ultrasound may be worthwhile.
Ultrasound—This procedure is not recommended as a routine screening test, but may be used as the next step if you are at high risk for ovarian cancer.
Blood tests—CA-125 is a substance that is found in elevated levels in many women with ovarian cancer. However, it is also elevated in women without cancer and is not elevated in all women who do have ovarian cancer, so it is not a very good test for screening all women. Your doctor may order this test if you are at high risk for ovarian cancer. Because there can be an association between breast and ovarian cancer, your doctor may also recommend screening for genetic predisposition to breast cancer, as well.

Screening Guidelines

Because of the low rate of early diagnosis, a great deal of research is being done to identify a screening test that meets the requirements for ease, safety, cost, and accuracy. Until then, have a pelvic exam yearly, and ask your doctor if you have any risk factors that would warrant an ultrasound. Currently, most insurers will not cover ovarian cancer screening tests, including a periodic CA-125 level or a transvaginal ultrasound. You may have to pay for this yourself or rely on reporting any new symptoms to your gynecologist as soon as possible to have the tests conducted.

References:

Kasper DL, Harrison TR. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.

Ovarian cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/ovarian/. Accessed April 8, 2009.

Last reviewed February 2009 by ]]>Igor Puzanov, MD]]>

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.