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 related to ovarian cancer, health care providers often order an ultrasound of the pelvic area and a blood test (“CA-125”). 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 have a normal CA-125 level, which could be falsely reassuring.

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, health care providers will often do surgery to check the ovary for cancer. Sometimes the ovary or other organs are removed. One major study showed that 15 women out of 100 had complications from surgery. Even with a laparoscopy, a surgery done through a tiny cut with very small surgical tools, there’s a risk of injury.

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 may be added costs for hormone therapy that may be used for many years depending on the individual’s age and symptoms. 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 health care provider feels something abnormal on a physical exam, these tests may help diagnose the problem.

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

  • A family history of ovarian, breast, uterine, or colon
  • Or, inherited risks, such as the BRCA1, BRCA2, BRIP1, RAD51C, RAD51D, and Lynch syndrome gene mutations. These are major risks of ovarian

If you have ovarian cancer, the CA-125 test can be helpful. Your health care provider 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.

© 2021 ABIM Foundation. Developed in cooperation with the  Society of Gynecologic Oncology.

08/2021