Ovarian cancer

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Cancer affecting the ovaries.

Diagnosis of ovarian cancer

QuotationMarkLeft.png GPs and practice nurses should offer women, particularly those over the age of 50, a blood test to measure the level of a protein called CA125 if they present with frequent symptoms of bloating, feeling full quickly, lower abdominal pain and needing to urinate urgently or frequently.

Women with high levels of CA125, 35 IU/ml or greater, should then be offered an ultrasound scan of their abdomen and pelvis.

If this suggests ovarian cancer, they should then be referred to see hospital specialists within two weeks. QuotationMarkRight.pngNICE news feature

Screening for this cancer is not recommended, as the tests available do not meet the criteria for a screening test. Recommendations on the use of the CA125 tumour marker, was published by NICE in 2011.[1]

NICE presented a risk of malignancy index calculation and suggest referral for women with a score of 250 or above.

Risk of malignancy index I (RMI I) RMI I is a product of the ultrasound scan score (U), menopausal status (M) and serum CA125 level. RMI I = U * M * CA125

The ultrasound result is scored 1 point for each of the following characteristics:- multilocular cysts, solid areas, metastases, ascites bilateral lesions.

U = 0 for an ultrasound score of 0 points, U = 1 for an ultrasound score of 1 point, U = 3 for an ultrasound score of 2–5 points.

Menopausal status is scored as 1 = pre-menopausal and 3 = post-menopausal. 

‘post-menopausal’ is taken to be a woman who has had no period for more than 1 year or a woman over 50 who has had a hysterectomy.

Serum CA125 is measured in IU/ml.