About 25% of ovarian cancers are found at an early stage. Early detection improves the chances that ovarian cancer can be treated successfully. When ovarian cancer is found early at a localized stage, about 90% of patients live longer than 5 years after diagnosis.

Regular women’s health examinations: During a pelvic exam, the health care professional feels the ovaries and uterus for size, shape, and consistency. Although a pelvic examination is recommended because it can find some reproductive system cancers at an early stage, most early ovarian tumors are difficult or impossible for even the most skilled examiner to feel. Pelvic exams may, however, help to identify other cancers or gynecologic conditions. Women should discuss the need for these exams with their doctor.

Although the Pap test is effective in detecting cervical cancer early, it cannot detect most ovarian cancers. Most of the ovarian cancers that are detected through Pap tests are already advanced.

See a doctor if you have symptoms: Early cancers of the ovaries tend to cause symptoms that are relatively vague. These symptoms include abdominal swelling (due to a mass or accumulation of fluid), unusual vaginal bleeding, pelvic pressure, back pain, leg pain, and digestive problems such as gas, bloating, indigestion, or long-term stomach pain. Most of these symptoms can also be caused by other less serious conditions.

By the time ovarian cancer is considered as a possible cause of these symptoms, it may have already spread beyond the ovaries. Also, some types of ovarian cancer can rapidly spread to the surface of nearby organs. Nonetheless, prompt attention to symptoms can improve the odds of early diagnosis and successful treatment. If you have symptoms of ovarian cancer, report them to your health care professional right away.

Screening tests for ovarian cancer: Screening tests and examinations are used to detect a disease, such as cancer, in people who do not have any symptoms. Women with a high risk of developing epithelial ovarian cancer, such as those with a very strong family history of this disease, may be screened with transvaginal sonography (an ultrasound test performed with a small instrument placed in the vagina) and blood tests.

Transvaginal sonography is helpful in finding a mass in the ovary, but it does not accurately detect which masses are cancers and which are benign diseases of the ovary.

Blood tests for ovarian cancer may include measuring the amount of CA-125 (also known as OC-125). The amount of this protein in the blood is higher in many women with ovarian cancer. However, some noncancerous diseases of the ovaries can also increase the blood levels of CA-125, and some ovarian cancers may not produce enough CA-125 to cause a positive test result. When these test results are positive, it may be necessary to do more x-ray studies or to take samples of fluid from the abdomen or tissue from the ovaries to find out if a cancer is really present.

In preliminary studies of women at average risk of ovarian cancer, these screening tests did not lower the number of deaths caused by ovarian cancer. For this reason, transvaginal sonography and the CA-125 blood test are not recommended for ovarian cancer screening of women without known strong risk factors. In women at high risk, these tests are often done, but it is not known how helpful they are. Ways to improve ovarian cancer screening tests are being researched. It is hoped that further improvements will make these tests effective enough to lower the ovarian cancer death rate.

There are no tests recommended to screen women for germ cell tumors or stromal tumors. Some germ cell cancers release certain protein markers such as human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) into the blood. After these tumors have been treated by surgery and chemotherapy, blood tests for these markers can be used to determine if the cancer may be coming back.

There are new tests that may be helpful in the future to diagnose ovarian cancer early. Please see "What’s New in Research and Treatment of Ovarian Cancer" at the end of this document.

Revised: 09/08/2004