Gynecologic CancerOur Gyno Health

Do You Need this Ovarian Cancer Test?

Ovarian cancer is very deadly. Almost 3/4 women ever diagnosed has advance disease which has a 5 year survival rate of only 20%.Like other diseases if we can diagnose early , the survival rate could be as high as 93%. What is more confusing is that many cases categorized as ovarian cancer have their origin in the fallopian tube.

Any testing that helps that diagnosis is viewed by all women as very important. A woman in the United States has a 1% chance of being diagnosed with ovarian cancer in her lifetime.

Screening tests are meant to be used by women with no symptoms, and can be tailored to whether you are low risk , or high risk, for ovarian cancer.

Do not ignore symptoms, if you have symptoms you should be evaluated, in person, promptly. These symptoms can be as subtle as increased abdominal girth or a feeling of abdominal distention.

We cannot just test every woman, so we have to decide who needs an ovarian cancer test. Just to discuss testing and genetic screening, telemedicine visits through Women’s Health Practice are very helpful.

Women and their providers are warned that ovarian cancer screening is not simple, not very accurate yet, and should never replace continued vigilance with respect to symptoms. Ovarian cancer is the quiet cancer: subtle signs are often present and can bring a case to detection.

Women who have screening for ovarian cancer are warned by the FDA that there are some tests with false claims and the tests should not be overly interpreted. At Women’s Health Practice we want our patients to know that there are ways to prevent ovarian cancer, and for those at risk, we encourage medical discussion to see if in fact you are doing all you can to prevent ovarian cancer. There are still women who can benefit by screening, and evaluating your screening process as new information becomes available is important.

Abbott Diagnostics and Fujirebio Diagnostics, did FDA: clearance of their blood test for ovarian cancer. The test, is to detect extremely small particles from the blood stream that may have been shed from the surface of an ovary, and more likely from an ovary with an ovarian cancer. This relatively new test is testing for Architect human epididymis protein 4 [HE4].

CA125 testing, with pelvic ultrasound, and a pelvic exam may be useful tests for ovarian cancer. Only 8 of 10 ovarian cancers express CA 125. More are thought to express HE4, so this new test has possible potential to improve screening some day.

We no longer think that women who previously underwent fertility treatment should be more intensely screened for ovarian cancer than just her yearly pap smears. One study done Whittemore and researchers reported in the American Journal of Epidemiology that there was an association of ovulation inducing medications and ovarian cancer. This has then been looked at again, but follow up of these women has been difficult. Even though some studies followed women for up to 15 years, that still left the women far younger than many women who get ovarian cancer. There was slight risk, but most risk would be countered by getting pregnant or using birth control pills and thus the magnitude of risk is still thought to be so slight that just getting the normal screening in a low risk patient (pap smears and pelvic exams). For those with family history more may be indicated.

Anything we can do to try to find ovarian cancers when they are at the earliest stages is extremely important. The survival rate of women with early stage ovarian cancer is over 95%, so you have both a better chance of survival and a better chance of keeping your ovaries when you do get treated in an earlier stage.


Suzanne Trupin, MD, Board Certified Obstetrician and Gynecologist and owner of Women's Health Practice, Hada Cosmetic Medicine, and Hatha Yoga and Fitness

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