Question asked by: 
Date asked: 
Sep 2018

Why is general screening for early ovarian tumours identification by ultrasound not performed? (ie to find tumours before CA125 is secreted)

Why are ultrasound scans not used first for ovarian cancer screening?
Response by Joan - Target Ovarian Cancer Nurse Adviser

CA 125 is a chemical that always present in the body and although the level can rise in ovarian cancer, it can also rise in some non-cancerous conditions.  A transvaginal ultrasound (TVU) scan can find a mass or lump in the ovary but it can’t tell if it is cancer or not and most masses are non-cancerous. These are the standard tests used at present to detect ovarian cancer but they are not reliable enough to be used for screening.

Researchers have been looking at what would work best as regards screening for ovarian cancer in the UK. A major trial was done recently called the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) which looked at screening women in the general population. In essence, it involved a group of women having annual CA125 blood tests and if the levels were raised it was followed by ultrasound, and compared that to a group of women having annual ultrasounds with no blood tests, and compared both groups to women who had no screening tests.

The trial reported its results in December 2015, which showed that CA125 is generally a better test than ultrasound to pick up ovarian cancer and the group who had CA125 plus ultrasound had earlier diagnosis and possibly reduced mortality rates. Researchers are still working on all the data from UKCTOCS and other research is also being done to try to find better ways of screening for ovarian cancer. You can find out more about the UKCTOCS trial on the Cancer Research UK website.

Until a better test for population screening has been developed, awareness of the symptoms of ovarian cancer is very important. At the moment women are tested for ovarian cancer if they have symptoms like bloating, abdominal or pelvic pain, needing to pass urine more often and feeling full quickly. The symptoms usually get worse and become more persistent, happening on most days.

If women are worried that their symptoms are like those associated with ovarian cancer they should always discuss this with their GP.