Clinical Summary

Ovarian Cancer: Screening

February 13, 2018

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Population Asymptomatic women without a known high-risk hereditary cancer syndrome
Recommendation Do not screen for ovarian cancer in asymptomatic women.
Grade: D
Risk Assessment Women with certain hereditary cancer syndromes are at high risk for ovarian cancer. Women with a family history of ovarian or breast cancer may be at risk for a hereditary cancer syndrome and should discuss their family history with their health care professional. The clinical symptoms of ovarian cancer (eg, abdominal pain or pressure, bloating, constipation, urinary symptoms, back pain, or fatigue) are nonspecific and may be present in both healthy women and women with late-stage ovarian cancer; therefore, use of clinical symptoms for risk stratification for the early detection of disease is difficult.
Screening Tests The USPSTF does not recommend routine screening for ovarian cancer using any method. Transvaginal ultrasound and serum cancer antigen 125 testing are readily available procedures that are commonly used to evaluate women with signs or symptoms of ovarian cancer and have been evaluated in screening studies. Pelvic examination is also commonly performed to evaluate women with lower abdominal symptoms.
Treatments Treatment of ovarian cancer typically includes surgical treatment (staging or debulking) and intraperitoneal, intravenous, or combined chemotherapy.
Other Relevant USPSTF Recommendations The USPSTF recommends that women with a family history indicating they are at risk for a deleterious gene mutation (BRCA1 or BRCA2) be referred for genetic counseling and, if indicated, genetic testing. The USPSTF concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening with pelvic examination to detect a range of gynecologic conditions in asymptomatic, nonpregnant women.

For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to https://www.uspreventiveservicestaskforce.org