Ovarian cancer is particularly dangerous because its symptoms, such as a generalized discomfort in the abdomen and a heaviness in the pelvic area, are often overlooked or blamed on other causes. It affects nearly 22,000 women in the United States per year and kills 14,600, making it the fifth leading cause of cancer death among women. Whether and how you should be screened for the disease depends on your individual risk profile.
Basics
Ovarian cancer is most common in older women, with about two thirds of deaths from the disease occurring in women who are 55 or above. Its causes are not well established. Having children earlier in life and having more children seem to be protective, as the risk of getting the disease goes down with these factors. Having had breast cancer or having a family history of breast cancer plays in, suggesting elevated risk for ovarian cancer. The BRCA1 and BRCA2 genes also factor in, with mutations in them causing a few cases of the malignancy.
Types
Though there is no standardized screening for ovarian cancer, several tests may be used to detect the disease. In a pelvic exam, a doctor or other medical professional checks your body using a gloved hand. The medical provider will examine the vagina, the cervix, the ovaries and other anatomy. Ovarian cancer found in this way has usually reached an advanced stage. In a transvaginal ultrasound, a probe is inserted into the vagina to check the organs using high-energy waves of sound. A picture of the organs is displayed on a screen as what's called a sonogram. Sometimes doctors also test the level of a substance called CA 125 in the bloodstream. An elevated level can suggest the presence of ovarian cancer or certain other malignancies.
Normal Risk
Not everyone needs to be screened for ovarian cancer. The U.S. Preventive Services Task Force recommends against routine screening, as do some major institutions such as Memorial Sloan-Kettering Cancer Center. According to Memorial Sloan-Kettering, women at "average risk" include those who have no family history of ovarian cancer and no Ashkenazi Jewish heritage. If they've had breast cancer themselves at an age of 41 or greater, they are still considered average risk. Regular gynecological exams once a year are enough for this population.
Increased Risk
Increased risk for ovarian cancer means the woman's chance of getting it is three to six times that of the general populations. Among the factors to consider are having a first-degree relative with ovarian cancer, having had breast cancer before age 40 and Ashkenazi Jewish heritage. According to Memorial Sloan-Kettering, it is not clear that screening of women with "increased risk" saves any lives. If women do want screening with methods such as transvaginal ultrasound or CA-125 testing, the center suggests, they should get it in the context of clinical trials to test the usefulness of the screening. That way, they are contributing to the body of scientific knowledge.
Inherited Risk
Inherited risk is a term that means a woman has gene mutations, particularly in the BRCA1 or BRCA2 genes, that predispose her to ovarian cancer. Her risk of developing the disease is considered six times or more that of the general population. According to Memorial Sloan-Kettering, it is unknown whether regular screening can prevent ovarian cancer deaths even in women with inherited risk. Nonetheless, for women with known genetic risk, the cancer center recommends screening with both transvaginal ultrasound and CA-125 testing beginning between ages 30 and 40, depending on the particular mutation.
