Who this is for
No known hereditary syndrome: no screening. This is the group USPSTF's recommendation against screening covers: it "applies to asymptomatic women who are not known to have a high-risk hereditary cancer syndrome." A family history alone does not take a woman out of it; USPSTF sends her to a conversation instead: "Women with a family history of ovarian or breast cancer may be at risk for a hereditary cancer syndrome and should discuss their family history with their health care professional." ACOG makes that first step concrete: take a detailed personal and family history of breast, gynecologic and colon cancer, and use it to sort women into average or high risk.
A known or suspected hereditary syndrome: outside USPSTF's recommendation. USPSTF: "For example, women with BRCA1 or BRCA2 genetic mutations associated with hereditary breast and ovarian cancer are at high risk for ovarian cancer." It does not say what these women should do: "Management of a diagnosed hereditary cancer syndrome and prevention of ovarian cancer in these women is beyond the scope of this recommendation statement." ACOG says women with a strong family history of ovarian, breast or colon cancer, who may have hereditary breast and ovarian cancer syndrome (a BRCA mutation) or Lynch syndrome, should be referred for formal genetic counseling, and may be offered additional testing for early detection if appropriate. Committee Opinion 716 does not name that testing, an age to start or an interval. ACOG's detailed guidance on hereditary breast and ovarian cancer syndrome, Practice Bulletin 182, is open only to ACOG members and journal subscribers, and we could not read it, so this page prints no ACOG test, age or interval for women at high risk. USPSTF's separate recommendation on BRCA risk assessment, genetic counseling and genetic testing is being updated.
Symptoms: a woman with symptoms is outside the screening question, and is evaluated rather than screened. USPSTF lists the symptoms and warns how little they discriminate: "The clinical symptoms of ovarian cancer (eg, abdominal pain or pressure, bloating, constipation, urinary symptoms, back pain, or fatigue) are nonspecific and may be present in both healthy women and women with late-stage ovarian cancer; therefore, use of clinical symptoms for risk stratification for the early detection of disease is difficult." Its advice: "Women with a family history of ovarian or breast cancer or symptoms should discuss this with their health care provider." ACOG asks patients and their obstetrician-gynecologists to stay alert to symptoms that could point to ovarian cancer. It cites a case-control study in which new symptoms, present for less than 12 months and occurring on more than 12 days a month, raised the odds of ovarian cancer: a larger abdomen or bloating, pelvic or abdominal pain, and difficulty eating or feeling full quickly. ACOG adds that most women with these symptoms will not have ovarian cancer, because more common conditions cause them. ACS names bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, and urinary urgency or frequency, and says to report them to a health care provider right away if they happen consistently for more than a few weeks.
What each body recommends
- USPSTF Recommends against
- ACOG No proven strategy
- ACOG Genetic counseling
The USPSTF recommends against screening for ovarian cancer in asymptomatic women. This recommendation applies to asymptomatic women who are not known to have a high-risk hereditary cancer syndrome.
Our note: Final statement of February 13, 2018, consistent with the 2012 recommendation; no ages are stated. It covers screening by any method; on the pelvic exam it finds "a lack of evidence to support this." Women with a family history of ovarian or breast cancer are told to discuss it with their clinician, and management of a diagnosed hereditary syndrome is outside its scope. Not on USPSTF's in-progress list when checked October 9, 2026.
no strategy for early detection of ovarian cancer that reduces ovarian cancer mortality
Our note: An excerpt from the first sentence under Recommendations and Conclusions in Committee Opinion 716, developed with the Society of Gynecologic Oncology; the sentence presents it as the current state of evidence. Dated September 2017, no day, so we record the first; reaffirmed 2024. No grade. ACOG states a finding, not a recommendation against screening. Its next conclusion, paraphrased: transvaginal ultrasound and tumor markers such as CA-125, alone or together, have not been shown to reduce mortality in average-risk women, and false positives cause harm through invasive tests such as surgery.
should be referred for formal genetic counseling to better assess their cancer risk
Our note: An excerpt from the Committee Opinion 716 section Determining Risk of Ovarian Cancer; the sentence opens with the women in this row. ACOG adds, paraphrased, that if appropriate these women may be offered additional testing for early detection. The opinion names no test, age or interval. ACOG's detailed bulletin on hereditary breast and ovarian cancer syndrome (Practice Bulletin 182) is members-only, so this page prints no ACOG test, age or interval for this group.
How they compare
On the substance the two bodies agree: no test or combination tested so far, transvaginal ultrasound, CA-125 or both, has lowered ovarian cancer deaths in women at average risk, and false positives lead to surgery on women who do not have cancer. USPSTF's 2018 survey of other groups opens: "There is consensus among major medical and public health organizations that screening for ovarian cancer in the general population is not recommended."
They differ in form, and the difference is worth reading correctly. USPSTF issues a graded recommendation against screening, grade D in 2018, consistent with its 2012 statement. ACOG's Committee Opinion 716 does not phrase its own position as a recommendation against screening. It states a finding, that no early-detection strategy reduces mortality, and a harm, that false positives lead to invasive testing such as surgery. USPSTF's summary of other groups describes ACOG as not recommending screening "in low-risk, asymptomatic women"; that is USPSTF's wording, not ACOG's.
On symptoms they lean differently without colliding. USPSTF stresses that symptoms are nonspecific; ACOG asks clinicians and patients to stay alert to persistent new ones. Both send a woman with symptoms to her clinician.
On high risk, USPSTF draws its line at a known hereditary cancer syndrome and routes family history to its separate BRCA recommendation, which is being updated. ACOG routes a strong family history to formal genetic counseling and possible additional testing, and keeps the details in a members-only bulletin. Neither endorses tests sold directly to consumers: USPSTF's recommendation covers any method, and ACOG found insufficient evidence for those marketed straight to women, such as the Risk of Ovarian Cancer Algorithm and multi-marker panels.
3 documents set the numbers on this page. The oldest was published in 2017, the newest in 2026.
- USPSTF recommendation
- ACOG recommendation
- Ovarian Cancer Early Detection, Diagnosis, and Staging (last revised March 16, 2026) 2026
We last re-read these sources on . How we verify.
What the test involves
Neither body recommends a screening schedule for women at average risk. These are the tests a woman may meet when she has symptoms or a high-risk plan, and why each misleads as a screen.
- Transvaginal ultrasound. ACS: it can find a mass on an ovary but cannot tell whether it is cancer, and most masses found in screening are not cancer. ACOG reports that in the large UK trial UKCTOCS, annual ultrasound led to surgery for about 10 women with false-positive results for each woman found to have ovarian or peritoneal cancer, with no mortality benefit over no screening.
- CA-125 blood test. ACS: not a reliable screening test, because benign conditions such as endometriosis and pelvic inflammatory disease raise it, and not every ovarian cancer does. ACOG: fixed CA-125 cutoffs have poor sensitivity and specificity for early-stage cancer, and no evidence shows CA-125 alone, at a fixed cutoff or tracked over time, has an acceptable positive predictive value or lowers mortality.
- CA-125 read by an algorithm (ROCA). USPSTF, on the UKCTOCS arm that used it: "Cumulatively, in all subsequent screening rounds (ie, rounds 2 to 11) in the UKCTOCS CA-125 ROCA group, 44.2% of women who did not have ovarian cancer (including primary peritoneal cancer) had a positive CA-125 ROCA result at some point during the trial screening period."
- Pelvic examination. USPSTF finds a lack of evidence that it works as an ovarian cancer screen (quoted above).
If the result is abnormal
A positive screening result in a woman at average risk leads to more tests and often to surgery. USPSTF: "The evaluation of abnormal test results consists of repeat testing with the same or a different test and often surgical removal (by laparoscopy or laparotomy) of 1 or both of the ovaries and fallopian tubes to determine whether a woman has ovarian cancer." And most positives are wrong: "The positive predictive value of screening tests for ovarian cancer is low, and most women with a positive screening test result do not have ovarian cancer (ie, many women without ovarian cancer will have a false-positive result on screening tests)."
The trials USPSTF reviewed put numbers on it. Surgery to investigate a positive result in women who turned out not to have ovarian cancer occurred in 0.2% of participants in the UK Pilot CA-125 group, 0.97% in the UKCTOCS CA-125 ROCA group, 3.25% in the UKCTOCS ultrasound group and 3.17% in the PLCO CA-125 plus ultrasound group, and "Up to 15% of these women had major surgical complications." USPSTF found that the screening did not reduce deaths. In UKCTOCS, 202,638 postmenopausal women aged 50 to 74, ovarian cancer mortality was "0.35% in the control group, 0.32% in the transvaginal ultrasound group, and 0.32% in the CA-125 ROCA group". In PLCO, 68,557 women aged 55 to 74, it was "0.34% in the screening group and 0.29% in the usual care group (relative risk, 1.18 [95% CI, 0.82 to 1.71])". Its verdict: "The USPSTF concludes that there is at least moderate certainty that the harms of screening for ovarian cancer outweigh the benefits." It adds that the recommendation rests on this evidence, "not on the costs of screening."
More on this screening
Frequently asked questions
Should I get a CA-125 test?
Not as a screening test if you have no symptoms and no known hereditary syndrome. USPSTF (2018) found adequate evidence that CA-125, transvaginal ultrasound or both do not reduce ovarian cancer deaths, and ACOG (2017, reaffirmed 2024) says tumor markers such as CA-125 have not been shown to lower deaths in average-risk women. ACS notes that benign conditions such as endometriosis and pelvic inflammatory disease raise CA-125, and that not every ovarian cancer does. With symptoms it is a different question: USPSTF notes that transvaginal ultrasound and CA-125 are commonly used to evaluate women with signs or symptoms of ovarian cancer. If you have symptoms, see your clinician.
My mother or sister had ovarian or breast cancer. Should I be screened?
Start with your family history, not a screening test. USPSTF says women with a family history of ovarian or breast cancer may be at risk for a hereditary cancer syndrome and should discuss it with their health care professional. ACOG says women with a strong family history of ovarian, breast or colon cancer should be referred for formal genetic counseling. USPSTF's separate recommendation on BRCA risk assessment and genetic testing is being updated, so ask your clinician directly about a genetic counseling referral.
Does my yearly pelvic exam check for ovarian cancer?
Not in any way the evidence supports. USPSTF: "although many clinicians perceive that pelvic examination with bimanual palpation of the ovaries is useful for screening for ovarian cancer, there is a lack of evidence to support this." ACS adds that Pap and HPV tests only rarely detect ovarian cancer.
What symptoms should I take seriously?
Symptoms that are new and persistent. ACOG cites a study in which a larger abdomen or bloating, pelvic or abdominal pain, and difficulty eating or feeling full quickly, new within the past 12 months and present on more than 12 days a month, raised the odds of ovarian cancer. ACS says to report bloating, pelvic or abdominal pain, trouble eating or feeling full quickly, and urinary urgency or frequency right away if they happen consistently for more than a few weeks. USPSTF warns that these symptoms are nonspecific and also occur in healthy women, and ACOG notes that most women with them do not have ovarian cancer. Persistent new symptoms are still a reason to see your clinician.
Should I buy an ovarian cancer screening test sold directly to consumers?
Not as a screen. ACOG's Committee Opinion 716 covers tests sold directly to women, including the Risk of Ovarian Cancer Algorithm and multi-marker panels: it found insufficient evidence to support them for early detection in average-risk women, and says women considering buying one should be counseled on its risks. USPSTF does not recommend ovarian cancer screening by any method, and it describes the workup of an abnormal screening result as repeat testing and often surgical removal of one or both ovaries and fallopian tubes.
I have a BRCA mutation. What is my screening schedule?
Neither body on this page gives one we can print. USPSTF's recommendation excludes you and calls management of a diagnosed hereditary syndrome beyond its scope. ACOG says women at high risk may be offered additional testing for early detection after genetic counseling, but Committee Opinion 716 names no test, age or interval, and ACOG's detailed bulletin is open only to members and subscribers. ACS reports that some organizations say transvaginal ultrasound and CA-125 may be offered to women at high risk, and that even in these women the tests have not been proven to lower the chance of dying from ovarian cancer. Build the plan with a genetic counselor and your gynecologic care team.