Ovarian Cancer Screening and Diagnosis

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Screening tests check for a condition, like cancer, in people who don’t have any signs or symptoms. There aren’t any standard screening tests for ovarian cancer if you’re at average risk. The best ways to detect this disease as early as possible are to get regular pelvic exams, even if everything seems fine, and see your primary care provider or gynecologist if you have any signs or symptoms that concern you.

If you are at high risk, Fred Hutch Cancer Center has a special program to help. Our Breast and Ovarian Cancer Prevention Clinic offers a personalized approach to risk assessment, screening and prevention for people at high risk.

Take Charge of Your Health

Talk to your primary care provider if you have symptoms that you think may be ovarian cancer. UW Medicine Primary Care can help you get started. Learn about Fred Hutch's relationship with UW Medicine. 

History and Exam for Ovarian Cancer

If you have signs or symptoms that could be from ovarian cancer (or another problem with your reproductive organs), your provider will ask you about your symptoms, your health history and your family history. They may ask about factors that might put you at risk for cancer or other conditions that might cause the same symptoms.

Then, they’ll examine you to check for clues about what’s been bothering you. They will probably do a general physical exam and then a pelvic exam.

Based on your conversation and exam, your provider may order tests to get more information.

Tests for Ovarian Cancer

To diagnose cancer, physicians have to remove a small sample of tissue and look at the cells under a microscope. This is called a biopsy. Other tests, either before or after a biopsy, may help your provider make a diagnosis.

Transvaginal Ultrasound (TVUS) for Ovarian Cancer

An ultrasound uses sound waves to make a picture of tissues inside your body. For concerns about reproductive organs, your provider might recommend a method where they put a slim ultrasound wand into your vagina to create an image of the nearby tissues, including your ovaries.

This approach may help your provider check the health of your ovaries and see a mass that’s not normal. It can help them tell if the mass is a solid tumor or fluid-filled cyst. It doesn’t tell them if a tumor is cancer.

CA-125 Test for Ovarian Cancer

CA-125 (cancer antigen-125) is a protein that’s a tumor marker. Tumor markers are substances that might show up in tests, or might be higher than normal, if you have cancer. Your CA-125 level might be high if you have ovarian cancer. But that’s not true for everyone. And some other conditions (that aren’t cancer) can raise CA-125 levels.

By itself, this type of blood test doesn’t show if you have ovarian cancer. But your provider might do this test (or other tests for tumor markers) as part of the diagnostic process.

Fred Hutch scientists are working to develop other biomarkers, molecules that indicate the presence of cancer, to help physicians detect ovarian cancer early.

Imaging Studies for Ovarian Cancer

Your provider may also want you to have imaging studies as part of the diagnosis process. These could give your care team more information, such as whether your cancer has spread.

Imaging might include an X-ray, ultrasound, computed tomography (CT) scan and magnetic resonance imaging (MRI) scan.

Biopsy for Ovarian Cancer

For ovarian cancer, physicians typically do biopsies on your tumor when you have surgery to remove it, not before. Your gynecologic oncologist may also take samples of tissue from around your pelvis and abdomen to check for cancer cells. This helps them figure out the stage of your cancer and design your treatment plan.

In some cases, physicians may do:

  • Needle biopsy — passing a needle through your skin to take cell samples without surgery. This is a way to check areas where your physician thinks cancer has spread.
  • Laparoscopic biopsy — passing tiny tools and a thin tube with a camera on the end through small cuts (incisions) in your abdomen. You might have this type of biopsy if you aren’t having surgery to take out the tumor or if your physician thinks it will be best to start with chemotherapy before surgery.
  • Paracentesis — using a long needle to take samples of ascites (extra fluid that has built up in your abdomen). A pathologist can check the fluid for cancer cells.
Dr. Barbara Goff
Dr. Barbara Goff is a Fred Hutch gynecologic oncologist and chair of the Department of Obstetrics & Gynecology at UW Medicine.

Why Choose Fred Hutch for Ovarian Cancer Care

When you choose Fred Hutch for care, our experts confirm your ovarian cancer diagnosis. Before your first visit, your care team will review your pathology slides (tissue samples from biopsies, if you’ve had any) and other scans or tests you’ve already had. We have a dedicated pathologist who specializes in diagnosing gynecologic cancers. If needed, we will do further tests.

During your first visit, you’ll see your gynecologic oncologist, who will ask about your medical history and symptoms and do an exam. Then, you’ll meet with the oncologist and other members of your care team to talk about what we found and what we recommend for you.

After your initial consultation, we’ll work with you so you can receive some of your treatment in your community, if you prefer.

“Once we evaluate the patient and establish their treatment strategy, we frequently partner with community oncologists to provide care closer to home,” said gynecologic oncologist Barbara Goff, MD. “This is especially helpful for patients who live outside the Seattle area.”

Ovarian Cancer Screening and Diagnosis FAQ

Genetic tests can help you learn about your risk for ovarian cancer. Using the results, you and your health care team can make a plan for prevention or early detection if you’re at high risk. Keep in mind that if you have a gene mutation or abnormal change that raises your risk, this doesn’t mean you will get ovarian cancer. Genetic tests cannot tell us who will or won’t get cancer for sure (and they don’t tell us if you have cancer already).

Physicians sometimes use transvaginal ultrasound for ovarian cancer screening in people at high risk. They may also use a CA-125 blood test. If you’re at high risk, ask your health care team which exams or tests they recommend for you. The Fred Hutch Breast and Ovarian Cancer Prevention Clinic creates personalized prevention and early detection plans for people at high risk.