Ovarian Cancer

Tests and investigations for ovarian cancer

Ian Jacobs, a professor of gynaecological oncology explains the tests used to diagnose ovarian cancer and assess its spread. These tests include an examination of the abdomen both externally and internally (vaginally and sometimes rectally), CA125 blood tests ('Treatment outcomes and follow-up'), and ultrasound scans. These scans use sound waves to make up a picture of the inside of the abdomen. This may be done by spreading a gel on the abdomen and passing a device over it, or by inserting a small device (about the size of a tampon) into the vagina.

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Women may also have one of several other types of scan such as CT or magnetic resonance imaging (MRI). Some have exploratory surgery or biopsies taken. If there is fluid in the abdomen (ascites) it may be drained both to relieve symptoms and to look for cancer cells. 

Some women we interviewed presented with an abdominal lump which their doctor suspected was a cyst or fibroid. Such lumps need further investigation and possibly biopsy and/or surgical removal to show whether they are benign or malignant. One woman had various diagnostic tests that confirmed her doctor's suspicion of an ovarian cyst that would need removal.

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Where a condition other than ovarian cancer was at first suspected, women had other tests such as colonoscopy, barium enema, urine tests, cervical screening tests and hysteroscopy before or at the same time as having an ultrasound scan that revealed their ovarian cancer.

Some women had tests done privately rather than in the NHS to shorten the wait or because they usually used private medical services.

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Most women with ovarian cancer already have advanced stage disease when they are diagnosed. This is because early stage ovarian cancer rarely produces symptoms, and because the symptoms of advanced disease are common and are usually caused by less serious conditions (see 'Symptoms'). Over the past decade much research has been done to see if screening well women using ultrasound scans and CA125 blood tests can detect ovarian cancer earlier and save lives. Some evidence already existed that these tests could detect the disease earlier, but our gynaecological oncologist, speaking in 2004, explains why screening has not yet been introduced and why a clinical trial involving many thousands of women was needed. The trial (United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) has now finished and the data analysed but further follow up of the women is needed before “firm conclusions can be reached”* about the benefits of screening.

*Jacobs, I J., Menon, U., et al. (2015). Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial The Lancet : 10.1016/S0140-6736(15)01224-6

Last reviewed June 2016.

Last updated June 2016.

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