Ovarian cancer screening at Leeds Hospital

What is ovarian screening?

Ovarian screening means checking for early signs of ovarian cancer before you have any symptoms, usually with a CA125 blood test or an ultrasound scan.

There's no screening programme offered to the whole population in the UK, though regular monitoring is now available through the NHS for people at the highest genetic risk.

Why might I need ovarian screening?

You might be offered ovarian screening or regular monitoring if you're at a higher risk of ovarian cancer. This can be because:

• you have a family history of ovarian cancer, such as a close relative who has had it
• you carry an inherited change in a gene linked to ovarian cancer, including BRCA1, BRCA2, RAD51C, RAD51D, BRIP1 or PALB2
• you have a condition such as Lynch syndrome or Peutz-Jeghers syndrome, which can raise your risk.

If your GP thinks you may be at higher risk, they can refer you to a genetic specialist to assess this properly. Not everyone with a family history of ovarian cancer turns out to be at increased risk themselves, so you can ask your GP to explain their reasoning if they decide a referral isn't needed.

Are there different types of test?

Yes. Ovarian screening and monitoring can involve:

• a CA125 blood test, used on its own or repeated every four months for ongoing monitoring
• a transvaginal ultrasound scan, carried out using a probe placed inside your vagina
• an abdominal ultrasound scan, carried out externally over your tummy.

A transvaginal scan can give a clearer view of your ovaries than an abdominal scan.

How do I prepare for ovarian screening?

Before any regular monitoring begins, you'll usually go through an assessment to check your risk:

• If you're concerned about your family history of ovarian cancer, speak to your GP
• Your GP may refer you to a genetic specialist, who can properly assess your risk level
• If you're found to be at high risk, you'll have counselling to talk through your options, which usually includes surgery to remove your ovaries and fallopian tubes
• If you can't have this surgery, or choose not to, you may then be offered a CA125 blood test every four months instead.

What happens during ovarian screening?

What happens depends on which test you're having.

If you're having a CA125 blood test, a sample of your blood is taken and checked for your CA125 level.

If you're having a scan, this may be a transvaginal scan, with a probe placed inside your vagina, or an abdominal scan, carried out externally over your tummy.

What happens after ovarian screening?

You will be advised as to what time-frame you are likely to receive your results. You should usually get your results within a few weeks. If you're worried, you can call the hospital or GP for an update.

If your results suggest ovarian cancer, a specialist will explain what they mean and what happens next. A team of specialists, including a clinical nurse specialist, will be your main point of contact. Macmillan Cancer Support also runs a free helpline if you want to talk things through, on 0808 808 00 00 between 8am and 8pm every day.

You may need further tests to check the size of any cancer and how far it has spread, so your specialist team can plan the best treatment for you. If you're having regular monitoring because of a high genetic risk rather than a one-off test, you'll usually continue having the CA125 blood test every four months.

What are the risks?

Like all screening, this testing has limitations:

• Large trials found that screening did not reduce deaths from ovarian cancer in the general population, so a normal result cannot guarantee you're protected
• Ovaries can sometimes be too small to show up clearly on a scan, especially after the menopause, so a test could miss a genuine problem
• For those at high genetic risk, surgery to remove the ovaries and fallopian tubes remains the option doctors consider safest; choosing regular blood tests instead means accepting some ongoing risk while your ovaries stay in place.