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Ask An Expert: Test for Ovarian Cancer
Question:
What test should be done to detect ovarian cancer?
Answer:
Ovarian cancer is not common, but it is a leading cause of death in women. A reliable and safe method of early detection is an important goal, since survival is strongly related to stage at diagnosis. However, this goal has not yet been realized. Ovarian cancer is difficult to diagnose in early stages because it causes minimal symptoms. Also, the ovaries are located deep in the pelvis and thus are difficult to evaluate during a routine pelvic exam.
A screening test must be able to identify the disease early so effective interventions can be pursued. In addition, the test must be able to distinguish the disease in question from other conditions. Otherwise, women without cancer may be subjected to invasive and potentially dangerous interventions. Unfortunately, tests for ovarian cancer do not meet these two conditions for women at average risk for the disease.
A blood test for a tumor marker called CA 125 is very useful for following women with known ovarian cancer, because its level corresponds to the activity of the disease. However, it is not useful to screen women in the general population, because CA 125 levels are often normal in early stages of ovarian cancer. It is also not a specific marker for cancer. CA 125 levels often go up in many benign conditions, such as endometriosis and fibroids. Pelvic ultrasound has also been studied as a possible screening tool, but it too fails to reliably distinguish ovarian cancer from other conditions.
At the present time, it is recommended that women without a family history of ovarian cancer have an annual pelvic exam to evaluate the ovaries. Women with a family history of ovarian cancer are at higher than average risk. In this situation a blood test or ultrasound may be recommended.
Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.
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| Last updated: | January 24, 2007 |
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Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.
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