There are no diagnostic methods accurate enough to be used for routine screening of women without symptoms. Nonetheless, it is recommended that all women have an annual pelvic and rectal examination since an ovarian mass can occasionally be detected. A Pap smear will detect ovarian cancer in only 10 percent of women with the disease. Recent studies have shown that a serum tumor marker known as CA-125 is elevated in 80 percent of women with epithelial ovarian cancer. Unfortunately, this test is not accurate enough for screening all women for ovarian cancer. Approximately 2 percent of normal women will have an elevated CA-125 (normal is less than 35). Approximately 1 percent of normal women will have a CA-125 greater than 65. Because of the small incidence of a false-positive test, screening all women with CA-125 has not been recommended. A great deal of research is taking place exploring the use of CA-125 as well as other tumor markers for screening. Tumor markers are, however, useful for assessing response to therapy.
A pelvic ultrasound examination may become a part of the routine annual gynecologic examination in the future. This can be done using a minimally uncomfortable vaginal probe. It is used to examine the ovaries as well as the uterus . When used in combination with CA-125, it is fairly accurate in detecting ovarian neoplasms.
