There is no reliable screening test.
A number of standalone tests to screen for ovarian cancer are currently in development. However, none are supported by sufficient evidence. More time and larger sample groups are required to confirm their effectiveness.
In fact, the U.S. Federal Drug Agency (FDA) announced in September 2016 that women should not use any tests currently marketed as screening tests for ovarian cancer. The Agency clearly states that “there are currently no screening tests for ovarian cancer that are sensitive enough to reliably screen for ovarian cancer without a high number of inaccurate results.”
If you have signs and symptoms of ovarian cancer, your doctor should perform a:
complete pelvic exam
transvaginal or pelvic ultrasound
CA-125 blood test
These tests are most effective when used in combination. Doctors may also use a CT scan or PET scan as part of the diagnostic process. The only definitive way to determine if a patient has ovarian cancer is through a biopsy.
The doctor will touch the outside of your abdomen (palpate the abdomen) for masses and then, with fingers inside the vagina, try to feel your ovaries from the inside.
Be prepared with your medical history - your doctor will ask questions to help to detect ovarian cancer and to rule out other gynecological/medical conditions.
For more information:
clinical aspect of a pelvic exam (Mayo Clinic)
my first pelvic exam (SOGC)
In this test, a narrow probe is inserted into the vagina. The probe sends out high-frequency sound waves that bounce off the ovaries and produce echoes that are used to create a picture called a sonogram. Doctors examine the sonogram for echoes that might represent abnormal areas.
For more information on ultrasound:
Visit RadiologyInfo website
Although the CA-125 blood test is NOT a reliable early detection test for ovarian cancer, it is helpful as a diagnostic tool in postmenopausal women. In about 20 percent of advanced stage ovarian cancer cases and 50 percent of early stage cases, the CA-125 is not elevated even though ovarian cancer is present. This is why doctors generally use the CA-125 blood test in combination with a transvaginal ultrasound.
CT or CAT scan
If any of the tests suggest the presence of ovarian cancer, surgery may be advised to examine the cells and check for malignancy. In this case, the doctor should refer you to a gynecologic oncologist for the surgery (a doctor who specializes in reproductive cancers). Research has shown that when surgery is performed by a gynecologic oncologist instead of another physician, the patient’s outcomes are improved.
In all phases of your diagnosis and treatment discuss the results with your doctor. Ask questions, write down the responses and ask your doctor to clarify anything you don’t understand. If you have concerns, asking for a second opinion is an option.
Diagnosing ovarian cancer
The only definitive way to determine if someone has ovarian cancer is to examine tissue that has been removed through surgery or a biopsy. If a doctor suspects ovarian cancer, you should be referred to a gynecologic oncologist for surgery (laparotomy) that will help the doctor identify the mass and determine whether it is malignant or benign (not cancerous).
It will also determine the location of the tumour and the extent of its spread. Biopsies will be taken to confirm the diagnosis.
Getting a second opinion
A diagnosis of ovarian cancer may be overwhelming. You should be comfortable with your treatment plan. You may want a second opinion to confirm your doctor's recommendations. It's your right to seek a second opinion.
Depending on where you are in the course of your diagnosis and treatment, either your own family doctor or the gynecologic oncologist can refer you for a second opinion.