Patient Management and Screening

The workup for patients with symptoms of or suspected ovarian cancer^{1 2}—

• Physical exam (pelvic and rectovaginal).
• Cancer antigen (CA)-125 test.
• Transvaginal ultrasound (TVU).
• Suspicious findings need to be evaluated with surgery.
• Refer to or consult with a gynecologic oncologist if you suspect ovarian cancer.

Risk Assessment

• Assess the patient’s personal and family medical history (both maternal and paternal) for features that suggest a higher genetic risk. Refer to the Genetics of Gynecologic Cancer module in this curriculum for more information on risk assessment.
• Consultation or referral for genetic counseling might be warranted for patients at high risk. For more information about genetic counseling, refer to the Genetics of Gynecologic Cancer module within this curriculum.

Screening and Early Detection for Average-Risk Patients

• The United States Preventive Services Task Force (USPSTF) recommends against TVU and CA-125 in the general population because the harms of screening outweigh the benefits.
• Pap tests do not screen for ovarian cancer.
• A pelvic exam is not an effective or recommended screening test for ovarian cancer.

References

¹DeVita VT Jr, Lawrence TS, Rosenberg SA, DePinho RA, and Weinberg RA. Devita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology (8th ed.). Philadelphia: Lippincott Williams and Wilkins, 2008.

²Schottenfeld D, Fraumeni J Jr. Cancer Epidemiology and Prevention (3rd ed.). Eastbourne, UK; WB Saunders Co., 1982.