Screening for Ovarian cancer

August 2, 2011

Ovarian cancer is the fifth leading cause of cancer deaths among American women and has a very high mortality rate. The 5-year survival rate is 75% if the cancer is confined to the ovaries and decreases markedly in women in whom the disease has spread. Unfortunately, this cancer is frequently diagnosed later in the course of the illness, after the tumor causes compression of surrounding structures or ascites develop (fluid in the abdominal cavity). As a result, two thirds of women with ovarian cancer have advanced disease when they are diagnosed.

The screening tests for ovarian cancer have not been proven to be of benefit to average-risk women. Ultrasound is a potential screening modality and is very sensitive. However, it carries a very large false-positive rate that results in unnecessary invasive procedures. Likewise, neither the measurement of serum tumor markers (blood tests) nor pelvic examination are good tests to look for ovarian cancer due to their lack of precision in making the diagnosis. The pelvic examination can occasionally detect cancers, however, the early cancers are often not felt on examination because they are very deep in the pelvis and rather small. Pap smears may, on occasion, show malignant ovarian cells, but this is not a screening test for ovarian cancer. Routine ultrasound testing of women without symptoms has a very low yield in detecting ovarian cancer and generates a large number of false-positive results that require invasive procedures.

In summary, routine screening for ovarian cancer by ultrasound, serum tumor markers, or pelvic examination is not routinely recommended. Women who are at increased risk of developing ovarian cancer should discuss their situations with their health care providers.

SEE ALSO: Cervical cancer, Ovarian cancer, Uterine cancer

Category: Cancer Screening