Ovarian Cancer

proactive approach to ovarian cancer means knowing your risk, paying attention to symptoms, and using the right tests at the right time. For people at average risk, experts do not recommend routine screening with the CA-125 blood test or transvaginal ultrasound (TVUS) because these tests haven’t been shown to lower deaths when used in people without symptoms. That said, being proactive still matters: act early on persistent symptoms, get timely ultrasound if a pelvic mass is found, and consider genetic risk assessment if your family history suggests it. Large research studies show that broad screening of average-risk people with CA-125 and ultrasound does not reduce mortality, so the focus is on targeted, timely testing.


Signs & Situations (When to consider testing)

Be proactive—contact your clinician if symptoms last more than a few weeks:

  • Bloating, pelvic or lower belly pain/pressure

  • Feeling full quickly or loss of appetite

  • Urinary urgency or going more often

  • new ovarian (adnexal) mass on exam or imaging

  • Family history of ovarian/breast cancer or a known BRCA/Lynch variant (ask about genetic counseling/testing)

Routine screening is not advised for symptom-free, average-risk people. Proactive testing means acting early when there is a reason to test.


Why These Tests Matter

How proactive testing helps

  • When a mass is present: blood markers (CA-125HE4) and tools such as ROMA (Risk of Ovarian Malignancy Algorithm) can estimate the chance of cancer and guide referral to a gynecologic oncologist.

  • When risk is elevated: a brief risk assessment followed by genetic counseling/testing (for genes like BRCA1/2) helps tailor a personalized plan for you and your family.

Limits to understand

  • CA-125, HE4, TVUS, and ROMA are not screening tests for average-risk, symptom-free people and have notbeen shown to lower deaths when used that way.


What These Tests Measure (at a glance)

  • CA-125: a protein that can be high in ovarian cancer and in many noncancer conditions (like endometriosis). Best used with imaging when a mass is already found.

  • HE4: another marker sometimes used with CA-125.

  • ROMA: combines HE4CA-125, and menopausal status to sort patients with an adnexal mass into higher or lower risk groups before planned surgery (not a screening test).

  • Genetic testing: after a brief risk check and counseling, tests for BRCA1/2 and other genes (per guidelines) may be recommended for people with strong family history or known mutations.


How the Testing Process Works

  1. Risk & history: your clinician reviews symptoms and family history and may use a short risk tool to decide on genetic counseling/testing.

  2. Imaging first when a mass is suspected: most people start with transvaginal ultrasound to define the mass.

  3. Add blood markers as needed: CA-125 ± HE4 and ROMA can help decide on specialist referral when surgery is being considered.

  4. Next steps: simple cysts may be watched; suspicious findings are referred to a gynecologic oncologist.

  5. Follow-up: your plan may include repeat imaging or labs—being proactive means keeping those appointments and acting on changes early.


Interpreting Results (general guidance)

  • normal CA-125 or HE4 does not rule out cancer; a high result does not prove it. Results must be read with imaging and exam.

  • ROMA gives a risk category, not a diagnosis. It aims to improve appropriate referral when surgery is planned.

  • Genetic test results (positive, negative, or uncertain) should be reviewed in genetic counseling to understand what they mean for you and your family.

Always review results with a qualified healthcare professional.


Choosing Panels vs. Individual Tests (Proactive Pathways)

  • Average risk, no symptoms: stay proactive with symptom awareness and routine preventive care; do not use CA-125, HE4, TVUS, or ROMA for screening.

  • Pelvic/adnexal mass present: start with ultrasound; your clinician may add CA-125 ± HE4 and ROMA to guide referral decisions.

  • High-risk family history: begin with genetic risk assessment and, if indicated, testing; create a personalized plan with your clinician.


FAQs

Is there a simple blood test to screen for ovarian cancer?
No. CA-125 and HE4 are not good screening tests for average-risk people. They are most helpful after a mass is found or when risk is already high.

What is ROMA and when is it used?
ROMA combines HE4CA-125, and menopausal status to estimate the chance of malignancy in someone who already has a pelvic mass and is planning surgery.

How can I be proactive without screening tests?
Know your family history, act on ongoing symptoms, keep well-woman visits, and ask about genetic counseling if your history suggests higher risk.

Do pelvic exams catch ovarian cancer early?
Pelvic exams are not effective screening for ovarian cancer, but they’re still part of overall women’s health and may find issues that need follow-up.


Internal Links & Cross-References

  • Cancer Screening Hub

  • Women’s Cancer & Tumor Markers

  • Cervical Cancer

  • Breast Cancer

  • Multi-Cancer Early Detection (MCED)

  • Key Lab Tests: CA-125 • HE4 • ROMA • BRCA1/2 Panel • Lynch Syndrome Panel • Transvaginal Ultrasound (Clinical)


References 

  1. U.S. Preventive Services Task Force. Ovarian Cancer: Screening. Final Recommendation Statement. 2018.

  2. American College of Obstetricians and Gynecologists (ACOG). Early Detection of Epithelial Ovarian Cancer in Women at Average Risk. Committee Opinion, 2017.

  3. Society of Gynecologic Oncology (SGO). Ovarian Cancer Screening & Symptom Awareness—Consensus Statement. 2023.

  4. National Comprehensive Cancer Network (NCCN). Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, and Prostate. Version 1.2026.

  5. Menon U, et al. UKCTOCS: Ovarian cancer population screening and mortality after long-term follow-up. The Lancet. 2021.

  6. U.S. FDA. ROMA (Risk of Ovarian Malignancy Algorithm)—510(k) summary (indicated for women with an adnexal mass; not a screening test).


Available Tests & Panels

Tip: A proactive plan uses ultrasound first for a suspected mass, adds CA-125/HE4 (± ROMA) to inform referral, and includes genetic risk assessment when family history suggests higher risk. These tests are most helpful when there is a clear reason to test.

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The CA 125 Test measures the level of cancer antigen 125 in blood, a protein often elevated in ovarian cancer and some other conditions. While not used alone for diagnosis, it helps monitor treatment effectiveness, detect recurrence, or assess disease progression. Elevated CA 125 may also be seen in endometriosis, fibroids, or pelvic inflammation. Doctors use this test to support cancer management and track overall reproductive and abdominal health.

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Also Known As: CA 125 Tumor Marker, Cancer Antigen 125 Test

The CA 125 Test with HAMA Treatment measures levels of cancer antigen 125, a biomarker often elevated in ovarian cancer and some benign conditions. The addition of human anti-mouse antibody (HAMA) treatment minimizes assay interference, improving result accuracy. This test supports evaluation of suspected ovarian malignancy, monitoring of treatment response, and detection of disease recurrence.

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The CEA Test measures carcinoembryonic antigen levels in blood, a protein that may be elevated in certain cancers, especially colorectal, pancreatic, lung, breast, or ovarian cancer. It is not used alone for diagnosis but helps monitor cancer treatment, detect recurrence, and track disease progression. Elevated CEA can also occur in noncancerous conditions. Doctors use this test to support therapy decisions and provide insight into cancer management.

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Also Known As: Carcinoembryonic Antigen Test

The Inhibin A Test measures levels of inhibin A, a hormone produced by the ovaries and placenta. Abnormal levels may indicate ovarian function disorders, fertility issues, or serve as a marker in prenatal screening for chromosomal abnormalities such as Down syndrome. This test provides insight into reproductive health, hormone regulation, and pregnancy monitoring, supporting evaluation of ovarian and placental activity.

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The Inhibin B Test evaluates inhibin B concentration in blood to help assess reproductive health in both men and women. In women, it is used as an indicator of ovarian reserve, follicular function, and fertility potential, while in men, it reflects Sertoli cell activity, spermatogenesis, and testicular health. This test aids in understanding hormonal balance, fertility disorders, and reproductive system function.

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The Alpha-Fetoprotein (AFP) and AFP-L3 Test measures total AFP and the AFP-L3 fraction, which is more specific for liver cancer risk. Elevated AFP may indicate liver disease, germ cell tumors, or hepatitis, while AFP-L3 is strongly associated with hepatocellular carcinoma (HCC). Doctors order this test to assess liver function, screen high-risk patients, and monitor cancer treatment. Results provide critical insight into liver health and cancer detection.

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Also Known As: AFP Test, Total AFP Test, Alpha-Fetoprotein Tumor Markers, Alpha-Fetoprotein Test


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The hCG Qualitative Urine Test detects human chorionic gonadotropin in urine to confirm pregnancy. It provides a simple positive or negative result, making it similar to an at-home pregnancy test but performed in a clinical setting for greater accuracy. Doctors order this test to evaluate missed periods, early pregnancy symptoms, or before medical procedures.

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Also Known As: Pregnancy Urine Test, Urine hCG Test, Qualitative Human Chorionic Gonadotropin

The hCG Total Qualitative Test detects the presence of human chorionic gonadotropin in blood to confirm pregnancy. Unlike the quantitative test, it provides a simple positive or negative result rather than exact levels. Doctors use this test to confirm suspected pregnancy, evaluate early symptoms, or screen before medical procedures.

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The hCG Total Quantitative Test measures human chorionic gonadotropin levels in blood to confirm pregnancy and monitor its progression. It provides exact hCG values, helping detect ectopic pregnancy, miscarriage risk, and abnormal growths like trophoblastic disease. Doctors also use it to track fertility treatments and evaluate certain cancers. This test offers precise insight into pregnancy health, reproductive function, and overall hormone balance.

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Also Known As: Beta hCG Test, Quantitative Chorionic Gonadotropin Test

The Lactate Dehydrogenase (LDH) Test measures LDH enzyme levels in blood to assess tissue damage and overall health. Elevated LDH may indicate conditions such as liver disease, heart attack, anemia, infections, or certain cancers, while low levels are uncommon. Doctors use this test to help diagnose disease, monitor treatment effectiveness, and track cell damage. It provides valuable insight into metabolic activity and organ function.

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Also Known As: LD Test, LDH Test, Lactic Acid Dehydrogenase Test

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The CA 15-3 Test measures cancer antigen 15-3 levels in blood, often used to monitor breast cancer treatment and progression. Elevated levels may suggest advanced breast cancer, metastasis, or recurrence, while non-cancer conditions can also affect results. Doctors order this test alongside imaging and other labs to track therapy response or detect changes in disease status. Results help guide ongoing management of breast cancer and patient care.

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Also Known As: CA 15-3 Tumor Marker, Cancer Antigen 15-3 Test, CA-Breast Test, Cancer Antigen-Breast Test

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The Estradiol (E2) Test measures levels of estradiol, the primary form of estrogen, to evaluate reproductive and hormonal health. It helps assess menstrual irregularities, fertility issues, menopause status, and estrogen-producing disorders. In men, it aids in diagnosing hormonal imbalances. Doctors use the estradiol test to monitor hormone therapy, ovarian function, and conditions affecting puberty, bone health, and overall endocrine balance.

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Also Known As: E2 Test, Estrogen 2 Test

The Estradiol and Estrone Test measures two primary forms of estrogen to assess hormonal balance, ovarian function, and endocrine health. Estradiol, the most active estrogen, and estrone, the predominant form after menopause, provide insight into reproductive health, fertility, and menopausal transition. This test aids in evaluating estrogen-related disorders, hormone therapy monitoring, and overall endocrine function.


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The Estriol (E3) Test checks blood levels of estriol, an estrogen hormone important in pregnancy. It is commonly included in the second-trimester triple or quad screen to detect chromosomal disorders such as Down syndrome and assess placental function. Estriol testing helps monitor fetal growth and maternal hormone health. Low or abnormal levels may signal pregnancy complications, guiding further testing and prenatal care decisions.

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Also Known As: E3 Test, Estrogen 3 Test

The Estrogen Total Test measures all forms of estrogen in blood, including estradiol, estrone, and estriol, to assess reproductive and hormonal health. Abnormal levels may indicate menstrual irregularities, menopause status, infertility, or hormone-related disorders. Doctors order this test to evaluate fertility, monitor hormone therapy, and investigate symptoms such as hot flashes, irregular cycles, or abnormal bleeding. It provides key insight into endocrine and reproductive function.

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Also Known As: Total Estrogen Test, Estrogen Serum Test

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The Estrone (E1) Test measures estrone, one of the three main estrogen hormones, to assess reproductive and hormonal health. It helps evaluate ovarian function, menstrual irregularities, menopause status, and estrogen-related disorders. In men, estrone testing may detect hormonal imbalances or excess estrogen. Doctors use this test to monitor hormone therapy, fertility treatments, and conditions affecting bone health, metabolism, and overall endocrine balance.

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Also Known As: E1 Test, Estrogen 1 Test

The Testosterone Free and Total Test measures total testosterone and free, bioavailable testosterone in blood for both men and women. It helps diagnose hormone imbalance, infertility, low libido, erectile dysfunction in men, irregular periods, or PCOS in women. Doctors also order it to assess fatigue, mood changes, or muscle weakness and to monitor hormone therapy. This test provides key insight into reproductive, endocrine, and overall metabolic health.

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Also Known As: Bound and Unbound Testosterone, Uncapped Testosterone Test

The Testosterone Total Test measures total testosterone levels in blood to evaluate reproductive, sexual, and endocrine health. In men, it helps diagnose hypogonadism, infertility, erectile dysfunction, or low libido. In women, abnormal levels may indicate PCOS or hormonal imbalance. Doctors use this test to investigate fatigue, muscle weakness, or mood changes and to monitor testosterone therapy. It provides key insight into hormone balance and metabolic health.

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Also Known As: Total Testostone LCMS Test, Uncapped Testosterone Test

It can be hard to catch ovarian cancer in its early stages. One of the best ways to diagnose it is to run ovarian cancer tests in a laboratory.

If you or a loved one have been suffering from the symptoms of ovarian cancer, have a family history, or you've been diagnosed and want to check on your treatment, it's a good idea to get yourself tested.

If you're looking for more information about ovarian cancer lab tests and how they can help, read on.

What is Ovarian Cancer?

Ovarian cancer is an uncontrolled cell growth in a woman's reproductive system, originating within the ovaries. The ovaries are responsible for regulating estrogen and progesterone hormones and releasing an egg cell during a woman's monthly cycle.

There are three main types of ovarian cancer, based on where the abnormality originates. The most common type is epithelial tumors, where the cells grow in excess on the outer surface of the ovaries.

Less than two percent of ovarian cancer results from germ cell tumors, which start as egg cells or the cells that produce them. The last type, stromal tumors, originate in the connective tissue or cells that regulate hormones and are very rare.

How Do They Check for Ovarian Cancer?

A doctor may do a physical exam, ultrasound test, or bloodwork (such as the CA-125 cancer marker test) to determine if you have ovarian cancer. For many types of ovarian cancer, it is impossible to determine whether the tumor is malignant, borderline, or benign until after you have had it removed and/or had a biopsy.

Causes and Risk Factors

The causes for developing ovarian cancer are still unknown. Research is ongoing to determine possible causes or links between ovarian cancer and ovulation or an egg cell's release. Genetic changes and mutations that cause ovarian cancer are still being studied.

Risk factors for developing epithelial ovarian cancer include age, being overweight or obese, never having a full pregnancy or getting pregnant past 35 years of age, taking hormone therapy, having a family history of cancer, having a fertility treatment such as in-vitro fertilization, smoking, and having breast cancer.

Signs and Symptoms

Some common warning signs and symptoms of ovarian cancer include:

  • Bloating or feeling full too quickly
  • Abdominal or pelvic pain
  • Problems with urination such as needing to go often or badly
  • Constipation
  • Pain during sex
  • Back pain
  • Upset stomach
  • Fatigue
  • Changes in the menstrual cycle

It's important to note that many women with early ovarian cancer do not have symptoms. Besides that, many of the symptoms are fairly common or could not be linked to ovarian cancer.

If you or a loved one are experiencing a combination of these ovarian cancer symptoms, it's a good idea to get a screening test just to be safe. It is less likely to get an ovarian cancer diagnosis in the early stages because these symptoms don't typically present themselves until the later stages. 

Ovarian Cancer Tests

There are a few ovarian cancer lab tests for cancer monitoring to detect changes in cancer markers.

The CA-125 monitoring test is a blood test that monitors the amount of a certain tumor marker known as CA-125 in the blood. This test has benefits for tracking patients over time who have already had cancer since your doctor can watch to make sure levels stay low. If levels ever have a sharp increase, cancer may be back.

The CA-125 test is not as helpful in diagnosing ovarian cancer since a small percentage of healthy women have naturally high levels of this marker. Besides, there may also be instances of ovarian cancer in the body, even when the levels are low.

The He4 cancer monitoring test is a newer tumor marker test with the same function as the CA-125 test. This cancer monitoring test looks for a different cancer marker in the blood. This test is still new, so more research may be needed to determine if this test may one day help us diagnose ovarian cancer.

Other tests, including an MRI or CAT scan test, can help your doctor determine if you have a cyst or tumor in your ovaries or anywhere else in your abdomen. Your doctor may also recommend an ultrasound test, which is quick and accurate enough to determine if there are larger tumors or cysts.

These tests cannot determine whether the tumor or cyst is malignant or cancerous. A biopsy of the tumor in a laboratory can determine if the growth is malignant, borderline, or benign. 

Genetic Testing

Another type of cancer testing preventative test is the BRCA1/2 genetic mutation test. This test looks for mutations in the BRCA1 and BRCA 2 genes, which constitute a higher risk for developing ovarian and breast cancer.

These tests are only recommended for those with a genetic predisposition to cancer and do not tell whether you have active ovarian cancer or a current illness.

Benefits of Getting Tested

The benefits of cancer lab testing are that you can be prepared in the event of a future ovarian cancer diagnosis. Getting a baseline for your CA-125 or He4 levels can help you to stay informed about your body in order for you and your physician to make informed decisions about your health.

There's no need for insurance or doctor's referrals to order your tests online. You can get secure and confidential results online within 24 to 48 hours for most tests. This can help you to keep track of your condition to make sure you're on the path to recovery and alert you if there are any changes.

Make sure to consult with a doctor or other medical professional if you're unsure about what the results of your tests might mean. It's important to get treatment for cancer from a medical professional.

Take Charge of Your Health

If you or a loved one are in need of ovarian cancer tests for monitoring your condition, you don't have to wait for insurance or a doctor's referral. You can order your tests online with Ulta Lab Tests and take charge of your health today.