Ovarian cancer screening: a primary care guide

Ovarian cancer is a deadly disease, rarely diagnosed in early stages when the possibility for cure exists. A reliable screening technique would reduce the number of late-stage diagnoses and increase the long-term survival of ovarian cancer patients. Unfortunately, the absence of an identified premalignant phase of the disease makes it virtually impossible to develop an effective routine screening technique. This article reviews the risk factors related to the increased incidence of ovarian cancer. Advanced age and factors related to incessant ovulation, such as early menarche, late menopause, nulliparity, or few pregnancies, have been shown to increase a woman's chance of developing ovarian cancer. Also, a family history of endometrial, colon, breast, or ovarian cancers may increase the likelihood of developing the disease. The role of the primary care provider in the identification of high-risk individuals is reviewed, and currently available early detection test such as pelvic examination, CA-125, abdominal or pelvic ultrasound, and color-flow Doppler technique are summarized.