Exams and Tests

There are no reliable screening tests for ovarian cancer. Ovarian cancer is confirmed and staged by biopsies that are taken during laparotomy surgery.

Some initial exams and tests are done before surgery if ovarian cancer is suspected. These tests include:

• Your medical history, to check what symptoms you have and what your chance of developing ovarian cancer is.
• A physical exam, including a pelvic exam and Pap test. An ovarian lump may be felt during a pelvic exam. A rectovaginal exam may also be done to feel the pelvic organs.
• A complete blood count (CBC), to check for anemia and other abnormal blood values.
• A chemistry screen to check for liver and kidney problems.
• A human chorionic gonadotropin (hCG) level may be done to rule out pregnancy or an ectopic pregnancy.
• A cancer antigen 125 (CA-125) level, to measure a protein found on the surface of many ovarian cancer cells.
• A pelvic and transvaginal ultrasound to look for an ovarian lump.

Additional tests may be done before surgery to determine if other areas of the body are involved. These tests include:

• A pelvic or abdominal CT scan or MRI to check for the spread of cancer.
• A chest X-ray to check for the spread of cancer.

Early Detection

For most women, the United States Preventive Services Task Force (USPSTF) does not recommend having a CA-125 blood test or a transvaginal ultrasound to find ovarian cancer early.¹³ There is no evidence that having regular tests helps women live longer by finding ovarian cancer early. Still, experts recommend that women who have inherited a BRCA gene change and have not had their ovaries removed have a transvaginal ultrasound and a CA-125 blood test at least once a year, starting at age 35. Women who have inherited a BRCA1 gene change (not a BRCA2 gene change) may want to start having these regular tests as early as age 25.¹⁴