A number of tests can detect ovarian cancer. The most effective test depends on a person’s medical history and risk factors.

Ovarian cancer involves the growth of cancer cells or tumors in the ovaries. According to the American Cancer Society, more than 21,000 people in the United States will be diagnosed with ovarian cancer in 2022. And just under 14,000 will die from this disease.

Given the severity of ovarian cancer, testing is crucial. Read on to learn more about ovarian cancer tests and what to expect.

A doctor talking with a patient about ovarian cancer test results.Share on Pinterest
SDI Productions/Getty Images

As the Centers for Disease Control and Prevention (CDC) note, there is no single, most reliable screening process for ovarian cancer. Routine tests such as a Pap smear can detect cervical cancer, but not ovarian cancer.

For people who do not have an increased risk of ovarian cancer, there are no recommended routine screening tests.

For people who may have an increased risk, experts recommend keeping track of any unexpected health changes. The risk of ovarian cancer increases with age. People with a family history of breast and ovarian cancer also have a higher risk of developing ovarian cancer.

If doctors detect ovarian cancer early, around 94% of people will live for more than 5 years after the diagnosis.

If a doctor suspects ovarian cancer, they may order an ultrasound or another imaging test to look for a tumor. They may also order blood tests to look for markers that can indicate ovarian cancer.

The CDC explains how a person’s family history can affect their risk of developing ovarian cancer. Mutations in the BRCA1 and BRCA2 genes lead to nearly 40% of ovarian cancer cases in people with a family history of the disease.

Research shows that 5–25% of all ovarian cancer cases result from inherited mutations. People with the BRCA1 mutation have a 39–44% risk of developing ovarian cancer by the age of 80. This range is 11–17% for people who inherit the BRCA2 mutation. Both are far higher than the average risk of 1.21%.

The likelihood of carrying a BRCA1 or BRCA2 mutation is different for people in different demographic groups. Around 2% of people of Ashkenazi Jewish descent carry a harmful mutation, compared with 0.2 to 0.3% of the general population, for example. The types of mutations also differ among different populations.

Given these statistics, anyone with a family history of ovarian or breast cancer should consider taking extra steps to safeguard their health. Medical professionals may recommend having genetic testing.

Genetic counselors can analyze a person’s DNA to determine whether they might have a risk of developing ovarian cancer. Anyone with relevant genetic mutations can take preventive steps to minimize their risk.

A physical examination can help a medical professional detect findings that could point to ovarian cancer.

The most common of these is a pelvic exam, which may involve:

  • an examination of the inside of the vagina, using a tool called a speculum to widen the vaginal opening
  • an external exam of the vulva and vaginal opening
  • a rectovaginal exam, which involves checking the vagina and the rectum
  • an internal exam conducted by hand

Physically examining the pelvic area can help doctors identify possible signs of ovarian cancer. But as research shows, this technique alone is insufficient.

Advanced imaging tests can detect the growth of ovarian cancer tissues. The type of test that the doctor chooses depends on the person’s symptoms and medical history.

Pelvic and transvaginal ultrasound

Ultrasound tests send sound waves through the body via a thin tool called a transducer. The medical professional performing the test may also call it a wand or probe.

These waves bounce off of organs and tissues and relay the information to a computer, which creates a corresponding image of the inside of the body.

During a pelvic ultrasound, the medical professional moves the tool along the outside of the pelvic region. During a transvaginal ultrasound, they place it inside the vagina.

A transvaginal ultrasound provides an image of the ovaries. Looking at this scan, a doctor may be able to distinguish between harmless cysts and cancerous tumors.

Ultrasound testing is considered one of the most reliable diagnostic tools for ovarian cancer. However, in some instances, doctors require additional tests.

MRI scans

The MRI machine uses magnets to create images of the inside of the body.

They can be especially useful for looking at the brain and spinal cord. While doctors do not typically use them to detect ovarian cancer, MRI scans can help show whether cancerous cells have spread from the ovaries to other areas.

Detecting the spread of cancer can help medical professionals develop the best possible treatment plan.

CT scans

This type of imaging can help medical professionals visualize larger tumors, but it is less effective at showing smaller tumors that may result from ovarian cancer.

Even with this limitation, CT scans are about 70–90% effective at detecting ovarian cancer. Doctors often recommend them for people with ovarian cancer symptoms.

Blood tests

Certain components in blood may indicate the presence of ovarian cancer. The doctor may call these “biomarkers.”

The most common biomarker of ovarian cancer is a protein called CA-125. Levels of this protein in the blood are increased in about half of people with early stage tumors and 92% of people with late stage tumors.

For anyone with a high risk of ovarian cancer, a doctor may order a blood test to check levels of CA-125. And they may order this test regularly for anyone with an ovarian cancer diagnosis. A decrease in CA-125 levels typically means that the treatment is working against the cancer.

It is worth noting that CA-125 levels can rise for reasons other than cancer, such as stress or inflammation. This is why it helps to monitor changes in CA-125 levels over time.

The symptoms of ovarian cancer can vary from person to person, but some of the most common symptoms include:

  • unusual bleeding or discharge from the vagina
  • pain in the back or abdomen
  • pelvic pain or pressure
  • trouble eating or feeling unusually full
  • bloating
  • needing to urinate more
  • constipation

Anyone at risk of ovarian cancer should contact a doctor as soon as possible if they notice these or other symptoms. Only a medical professional can provide an accurate diagnosis.

People with a low risk of ovarian cancer generally do not undergo regular screening.

This group typically includes people who have:

  • no family history of ovarian cancer
  • been pregnant
  • breastfed
  • taken birth control pills

People with a high risk may undergo regular testing, depending on their doctor’s advice.

Older adults, people with certain genetic mutations, and people a family history of ovarian cancer may have a higher risk.

After receiving an ovarian cancer diagnosis, a person may undergo different treatments. The most common approach is a combination of surgery and chemotherapy, though this depends on how advanced the cancer is.

Learn about the stages of ovarian cancer here.

The person may have surgery to remove tumors throughout the body, or they may have a complete hysterectomy.

“Chemotherapy” refers to a group of drugs that help kill or shrink cancer cells. This treatment may come in the form of pills or an IV injection.

After chemotherapy, the doctor may recommend maintenance treatment to keep the disease in remission. This may involve taking a targeted cancer drug called a PARP inhibitor. This attacks cancer cells but does not affect healthy ones. “PARP” stands for poly adenosine diphosphate-ribose polymerase, and it is an enzyme that helps repair DNA damage.

Learn more about PARP inhibitors here.

In the United States, ovarian cancer develops in tens of thousands of people every year. When doctors detect it early, rates of successful treatment are high.

A physical exam may reveal signs that could indicate ovarian cancer. Then, a doctor uses imaging and blood tests to make an accurate diagnosis.

Anyone with a high risk of ovarian cancer should watch for any potential symptoms of the condition. A medical professional can then determine which tests are needed.