Screening for Ovarian CancerEn Español (Spanish Version)
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 are designed to find patient with early cancer or patients who are high risk. Whenever you go for a screening procedure, be certain to tell your screener if you have any high-risk factors, expecially 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 he or 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 healthcare provider 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 predicposition to breast cancer as well.
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.
Harrison's Principles of Internal Medicine. 14th ed. McGraw-Hill; 1998.
National Cancer Institute website. Available at: http://www.cancer.gov/ .
Last reviewed April 2007 by Barbara Harty-Golder, MD, JD
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