Screening Tests for Ovarian Cancer

When you need them—and when you don’t

Compared to other cancers, ovarian cancer is one of the more deadly. If a woman has symptoms that might be ovarian cancer, doctors often order a blood test (“CA-125”) and an ultrasound. But these tests aren’t good for screening of low-risk women. Here’s why:

The test results are not always effective.

Women with a high CA-125 level don’t always have ovarian cancer. Instead, they may have another cancer or a different condition such as cirrhosis, pelvic inflammatory disease, fibroids, or endometriosis. And half of women with early cancer had a normal CA-125 level.

Also, ultrasounds are not good at finding early ovarian cancer. They often show cysts that are benign (not cancer). This can lead to unnecessary surgery.

The tests can lead to risky procedures.

If a CA-125 test or ultrasound shows something that isn’t normal, doctors will often do surgery to check the ovary for cancer. The ovary is usually removed. One major study showed that 15 women out of 100 had complications from surgery. Even with a laparoscopy, there’s a risk of injury. The surgery is done through a tiny cut with very small tools.

Some women choose to have both ovaries removed during the procedure. This can cause early meno­pause, which can increase the risk of hip fractures, heart attacks, and possibly dementia.

The tests and follow-up can be costly.

A CA-125 blood test can cost $200 or more. An ultrasound costs $150 to $250. And surgery costs a lot more, especially if there are complications. For women who want both ovaries removed, there are added costs for hormone therapy for the rest of their lives. So, the tests can add costs and negatively affect your quality-of-life, and there may be no benefits.

When are the tests worth the risks?

The CA-125 test and an ultrasound may be helpful if you have symptoms of ovarian cancer.

Also, if your doctor feels something abnormal on a physical exam, these tests may help diagnose the problem.

You should talk to your doctor about being tested if you have a high risk of ovarian cancer, including:

  • A family history of ovarian, breast, uterine, or colon cancer.
  • Or, inherited risks, such as the BRCA1 or BRCA2 gene mutation or Lynch syndrome. These are major risks of ovarian cancer.

If you have ovarian cancer, the CA-125 test can be helpful. Your doctor can use the test to check if treatment is helping, or if the cancer has come back.

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2014 Consumer Reports. Developed in cooperation with the  Society of Gynecologic Oncology.