What is ovarian cancer screening ?
The gynecologist has three methods to detect ovarian cancer :
- Gynecological examination
- Pelvic ultrasound
- Blood test for a tumor marker, CA-125
Expert perspective
Tumor markers are molecules produced by tumor cells and found in the bloodstream . These markers are also produced by normal cells, so they are not specific to cancerous cells .
As a result, they are not used for cancer screening but rather as one of the elements in diagnosing cancer and, most importantly, in monitoring the progression of the disease during treatment. The level of these markers is measured in a blood sample taken during a blood test at a laboratory.
For ovarian cancer, the main marker is CA-125 . A blood level significantly higher than 35 U/ml can be a sign of ovarian cancer. About 50% of patients with localized ovarian cancer and 90% of patients with more advanced ovarian cancer show an increase in CA-125 levels.
An elevation in the level of this marker can also be observed in cases of breast cancer, endometrial (uterine) cancer, or lung cancer. This level may also rise in cases of benign conditions or during the first trimester of pregnancy. Another marker for ovarian cancer is HE4 , although its measurement is less commonly used.
However, when considered in isolation, none of these methods is sufficient. Several studies combining these methods have not demonstrated the benefit of organized screening in the general population.
On the other hand, screening is valid for women at high risk. This primarily includes women who have :
- A BRCA1 or BRCA2 mutation
- Non-polyposis colorectal cancer (Lynch syndrome)
- A family history of ovarian cancer
These patients may benefit from annual screening starting at age 35, which includes a gynecological examination, pelvic ultrasound, and CA-125 blood test. Additionally, for patients with a family history of ovarian cancer, a consultation with a genetic oncologist may be recommended.
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Article updated on Jan 9, 2025
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