Ovarian cancer

Last reviewed: 30 May 2022
Last updated: 11 Feb 2022

Summary

Definition

History and exam

Key diagnostic factors

  • pelvic mass
  • ascites
  • pleural effusion
More key diagnostic factors

Other diagnostic factors

  • gastrointestinal symptoms
  • urinary urgency or frequency
  • symptom duration >3 months
  • abdominal distention
  • pelvic/abdominal pain or pressure
Other diagnostic factors

Risk factors

  • BRCA1 mutation
  • BRCA2 mutation
  • increasing age
  • family history of ovarian cancer
  • family history of breast cancer
  • never used combined oral contraceptives
  • Lynch syndrome
  • nulliparity
  • obesity
  • hormone therapy
  • endometriosis
More risk factors

Diagnostic investigations

1st investigations to order

  • pelvic ultrasound
  • CA-125
  • histopathology
More 1st investigations to order

Investigations to consider

  • PET or PET-CT scan
  • MRI
  • CT scan
  • OVA1 assay
More investigations to consider

Treatment algorithm

ACUTE

surgical candidate, intraoperative histology confirmed disease

poor surgical candidate, biopsy confirmed disease

ONGOING

platinum-sensitive recurrent disease

platinum-resistant recurrent or refractory disease

Contributors

Authors

Sareena Singh, MD

Gynecologic Oncologist

Aultman Medical Group

Northeast Ohio Medical University

Canton

OH

Disclosures

SS declares that she has no competing interests.

Acknowledgements

Dr Sareena Singh would like to gratefully acknowledge Dr Justin C. Chura and Dr Allison E. Axtell, previous contributors to this topic.

Disclosures

JCC and AEA declare that they have no competing interests.

Peer reviewers

Michael P. Hopkins, MD, MEd

Chairman

Obstetrics and Gynecology

Northeast Ohio Universities of Medicine (NEOMED)

Rootstown

OH

Disclosures

MPH declares that he has no competing interests.

Ritu Salani, MD

Gynecologic Oncology Fellow

Johns Hopkins Medical Institutions

Baltimore

MD

Disclosures

RS declares that she has no competing interests.

Susan A. Davidson, MD

Associate Professor

Chief, Gynecologic Oncology

Department of Obstetrics & Gynecology (UCD)

University of Colorado Cancer Center

Aurora

CO

Disclosures

SAD declares that she has no competing interests.

Khadra Galaal, MBChB, MPH, MRCOG

Consultant Gynaecological Oncologist

Northern Gynaecological Oncology Centre

Queen Elizabeth Hospital

Gateshead

UK

Disclosures

KG is co-author of a systematic review of follow-up strategies after primary treatment in ovarian cancer. This is not referenced in this topic.

  • Ovarian cancer images
  • Differentials

    • Irritable bowel syndrome (IBS)
    • Metastases to the ovary
    • Endometriosis
    More Differentials
  • Guidelines

    • Ovarian epithelial, fallopian tube, and primary peritoneal cancer treatment
    • Updated treatment recommendations for newly diagnosed epithelial ovarian carcinoma from the ESMO clinical practice guidelines
    More Guidelines
  • Patient leaflets

    Ovarian cancer: what is it?

    Ovarian cancer: what treatments work?

    More Patient leaflets
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer