This article waslast modified on 10 July 2017.
Ovarian cancer is the fifth most common cancer in women in the UK and its incidence is rising. Symptoms are often non-specific and most women have them for months before seeing a doctor. On 27 April 2011 the National Institute for Health and Clinical Excellence (NICE) published guidelines for the recognition and initial management of the condition to help improve early diagnosis in the NHS.

NICE recommended that general practitioners (GPs) should refer women who have a mass or fluid in the abdomen to a cancer specialist urgently. Women who have persistent or recurrent symptoms of abdominal bloating, loss of appetite, abdominal pain, altered bowel frequency or stool form, or the need to pass urine frequently or urgently should be offered measurement of serum CA125 concentration. If the CA125 is raised to a level that suggests ovarian cancer, the GP should arrange for an ultrasound examination of the abdomen and pelvis. NICE then recommends the course of management depending on the ultrasound findings. Women who have a normal CA125 or a raised CA125 and a normal ultrasound should be reassessed clinically and monitored.

CA125 is raised in about 80% of women with ovarian cancer. However, it has not been used as a screening test for the disease because it is also raised in diseases such as pelvic inflammatory disease and endometriosis. GPs have been understandably reluctant to subject women with non-specific symptoms directly to ultrasound examination to detect this fairly rare disease. NICE have taken the sensible step of recommending that CA125 be used not as a screening test for ovarian cancer itself but for ultrasound examination.

A NICE booklet about the guidelines written for patients and carers is available here.