Should You Ask for a CA-125 Test or Ovarian Ultrasound?What the Task Force Says

Ovarian cancer is often found late, so it’s natural to want a test that catches it early. Some women ask for a CA-125 blood test or a pelvic ultrasound at their yearly visit, and some clinics offer them for a fee. Here is what the U.S. Preventive Services Task Force (USPSTF) found.

Why it matters after 50

Ovarian cancer causes about 14,000 U.S. deaths a year, and more than 95% occur in women 45 and older.¹

The screening recommendation

In 2018, the USPSTF found good evidence that screening women without symptoms does not reduce deaths from ovarian cancer.¹ It also found the harms are at least moderate, including surgery for women who turned out not to have cancer.¹ The Task Force recommends against screening women who have no symptoms and aren’t known to have an inherited high-risk syndrome.¹

That doesn’t apply if you carry a high-risk inherited change, such as in a BRCA gene, or have a strong family history. Ask about genetic counseling and a plan made for you.

What about the routine pelvic exam?

A separate 2017 statement found too little evidence to weigh the benefits and harms of a screening pelvic exam in women without symptoms.² That doesn’t change recommended screenings such as cervical cancer tests.² Our guide to how often you need a Pap test covers that.

Symptoms: when testing makes sense

Screening is for people without symptoms. If you have symptoms, testing is a different conversation. The CDC³ lists:³

• vaginal bleeding, especially after menopause, or unusual discharge
• pain or pressure in the pelvis, belly or back
• bloating
• feeling full quickly or trouble eating
• bathroom changes, such as needing to urinate often or urgently, or constipation

See a doctor right away for unusual bleeding. For the other symptoms, see a doctor if they last 2 weeks or longer and aren’t normal for you.³ They often have other causes, but only an exam can tell.³

Our articles on bleeding after menopause, small ovarian cysts after menopause and pelvic ultrasound explain related tests.

Questions to ask

1. Does my family history put me at high risk?
2. Should I see a genetic counselor?
3. Which symptoms should make me call you?

Try: “I’ve been bloated and full after small meals almost every day for three weeks. That isn’t normal for me. Can we look into it?”

Down There, Decoded includes a Down-There Log and a See script for appointments. Use them to track symptoms day by day so you can show how long they’ve lasted. Explore the intimate-health playbook.