If you're at average risk for ovarian cancer, there's no routine screening test to catch it before symptoms appear. Instead, the best defense is staying alert to your body and maintaining regular pelvic exams with your doctor. For people at high risk due to family history or genetic factors, specialized screening programs offer personalized approaches to early detection .

What Makes Ovarian Cancer Screening Different From Other Cancers?

Ovarian cancer screening doesn't follow the same playbook as mammograms for breast cancer or colonoscopies for colon cancer. There simply aren't standard screening tests recommended for people at average risk, which can feel counterintuitive in a healthcare landscape where preventive screening is emphasized for so many conditions. The challenge is that ovarian cancer often develops silently, without obvious early warning signs, making it harder to detect through routine screening alone .

This doesn't mean prevention isn't possible. Instead, the focus shifts to awareness and regular clinical care. Regular pelvic exams remain the cornerstone of early detection for average-risk individuals, even when everything feels fine. These exams give your doctor a chance to notice anything unusual before symptoms develop .

How to Protect Yourself Against Ovarian Cancer?

• Schedule Regular Pelvic Exams: Even without symptoms, routine pelvic exams with your primary care provider or gynecologist help catch abnormalities early. These exams are part of standard gynecologic care and should be part of your regular health maintenance.
• Report Symptoms Promptly: Pay attention to persistent pelvic pain, bloating, changes in bowel habits, or urinary symptoms that last more than a few weeks. Contact your doctor immediately if you notice anything concerning, as early reporting can make a significant difference in diagnosis timing.
• Know Your Family History: If relatives have had ovarian, breast, or colon cancer, discuss this with your healthcare provider. Family history is a key risk factor that may qualify you for specialized screening or genetic testing.
• Consider Genetic Testing if High-Risk: If you have a family history of ovarian cancer or carry genetic mutations like BRCA1 or BRCA2, genetic testing can help determine your actual risk level and guide personalized prevention strategies.

What Happens If Your Doctor Suspects Ovarian Cancer?

When you report symptoms or your doctor finds something unusual during an exam, the diagnostic process begins with a detailed conversation. Your doctor will ask about your symptoms, medical history, and family background to understand your risk factors and what might be causing your concerns. They'll then perform a thorough physical exam, including a pelvic examination .

Based on what they find, your doctor may order imaging tests or blood work to investigate further. Several diagnostic tools can help clarify whether a concern is cancer or something else entirely:

• Transvaginal Ultrasound: A slim ultrasound wand is gently inserted into the vagina to create detailed images of your ovaries and surrounding tissues. This test can show whether a mass is solid or fluid-filled, helping distinguish between cysts and tumors, though it cannot definitively diagnose cancer on its own.
• CA-125 Blood Test: This test measures a protein called cancer antigen-125 that may be elevated in people with ovarian cancer. However, this protein can also be high with other conditions that aren't cancer, so the test is used as part of the overall diagnostic picture rather than as a definitive answer.
• Imaging Studies: Depending on initial findings, your doctor may recommend X-rays, CT scans, or MRI scans to get a clearer picture of what's happening and whether cancer may have spread to other areas.

If cancer is suspected, a tissue sample (biopsy) is typically taken during surgery to remove the tumor, rather than beforehand. This approach allows your surgical team to fully assess the cancer's extent and stage while gathering the tissue needed for a definitive diagnosis .

Who Should Consider Specialized Screening Programs?

If you're at high risk for ovarian cancer, your approach to screening changes significantly. People with a strong family history of ovarian cancer, a personal history of breast cancer, or known genetic mutations may benefit from specialized screening. Fred Hutch Cancer Center and similar institutions offer dedicated programs that create personalized prevention and early detection plans for high-risk individuals .

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

Barbara Goff, MD, Gynecologic Oncologist at Fred Hutch Cancer Center

For high-risk patients, doctors may use transvaginal ultrasound and CA-125 blood tests as part of regular screening, even though these tests aren't recommended for average-risk individuals. Genetic testing can also help clarify your actual risk level. If you have a gene mutation that increases your ovarian cancer risk, this doesn't mean you will definitely develop cancer, but it does mean you and your healthcare team should create a plan for closer monitoring or preventive measures .

What Role Does Genetic Testing Play?

Genetic tests can reveal whether you carry mutations that significantly increase your ovarian cancer risk, such as changes in the BRCA1 or BRCA2 genes. However, it's important to understand what genetic testing can and cannot do. A positive genetic test means you have an increased risk, not a diagnosis of cancer. Conversely, a negative test doesn't guarantee you won't develop ovarian cancer, since most ovarian cancers don't result from inherited genetic mutations .

If genetic testing shows you're at high risk, your doctor can recommend appropriate screening intervals and prevention strategies tailored to your situation. This personalized approach is far more effective than a one-size-fits-all screening strategy, which is why genetic counseling and testing are valuable tools for people with family histories of cancer.

The bottom line is that ovarian cancer prevention and early detection require a partnership between you and your healthcare team. For most people, that means staying aware of your body, attending regular pelvic exams, and reporting any concerning symptoms promptly. For those at higher risk, specialized screening and genetic testing offer additional tools to catch problems as early as possible.