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Screening

There is no national screening programme for ovarian cancer in the UK. This is because there isn't a test that reliably picks up ovarian cancer at an early stage. 

What is screening?

Screening means testing people for early stages of a disease before they have any symptoms. For screening to be useful the tests:

  • need to be reliable at picking up cancers
  • overall must do more good than harm to people taking part
  • must be something that people are willing to do

Screening tests are not perfect and have some risks. The screening programme should also be good value for money for the NHS.

Research into tests

There is a lot of research looking into screening for ovarian cancer. Researchers have been looking at 2 main tests:

  • the CA125 blood test
  • transvaginal ultrasound.

CA125 blood test

CA125 is known as a tumour marker for ovarian cancer. A tumour marker is a chemical given off by cancer cells that circulates in the bloodstream. Women with ovarian cancer tend to have higher levels of CA125 in their blood than women who do not have ovarian cancer. But CA125 can also be raised for other reasons that are not related to cancer. So the test is not completely reliable.

This test would miss some cases of ovarian cancer if it was used on its own. It would also pick out other women who did not have ovarian cancer. They would then need to have further tests, which could cause them anxiety and harm.

We need to have another test that can reliably show who has ovarian cancer and who hasn't. Researchers are looking for other possible tumour markers for ovarian cancer. 

Transvaginal ultrasound

This is an ultrasound examination done by putting an ultrasound probe into the vagina. It gives a better picture of the ovaries than an ultrasound over the tummy (abdomen). Even so, it can still be difficult to tell whether there is a cancer on the ovary or just a harmless cyst.

There is no clear evidence so far that these tests can pick up cancers early and save lives. 

Research trials

A large study called UKCTOCS has looked at whether screening could be useful in ovarian cancer. So far there is not enough evidence for the NHS to introduce a national screening programme. So the researchers want to follow the women on the trial for a few more years. They want to see for sure whether screening does actually save lives, and to show how that balances against the harms (which include unnecessary surgery and potential complications).

What to do if you think you are at risk

You have a higher than average risk of developing ovarian cancer if 2 or more relatives on the same side of your family are diagnosed with ovarian cancer or breast cancer at a young age, particularly under the age of 50.

 Talk to your GP if you think you are at increased risk of ovarian cancer.

They can refer you to your local genetics service, who can assess you and may put you on the UK Familial Ovarian Cancer Registry. You will have counselling about your options, which may include regular tests to try to find ovarian or breast cancer at an early stage. The options may also include surgery to remove the ovaries, reducing your risk of developing ovarian cancer.

Last reviewed: 
23 Jan 2019
  • Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial

    I Jacobs and others

    Lancet. 2016 March 5;387(10022):945-56. 

  • Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

    J Ledermann and others; ESMO Guidelines Working Group

    Annals of Oncology. 2013 Oct;24 Suppl 6:vi24-32. 

  • Principles and practice of oncology (10th edition)
    V De Vita and others
    Lippincott, Williams and Wilkins, 2015

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Blackwell, 2015

  • British gynaecological cancer Society (BGCS) Epithelial Ovarian / Fallopian Tube / Primary Peritoneal Cancer Guidelines: Recommendations for Practice
    C Fotopoulou and others
    European Journal of Obstetrics and Gynecology and Reproductive Biology, April 2017.  Vol. 213, p123–139

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