The symptoms are vague, persistent and easy to mistake for IBS. There is no screening test — which is why symptoms matter.
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Ovarian cancer is diagnosed late more often than almost any other cancer, and the reason is not that women ignore symptoms — it is that the symptoms are genuinely unremarkable.
Bloating. Feeling full quickly. A vague ache. Needing to pass urine more often. Every one of those is more likely to be something ordinary, and most of the time it is.
Persistence and frequency. Symptoms that occur most days, for three weeks or more, and that are new for you — that is the pattern worth acting on.
There is no screening test for ovarian cancer. No blood test, no scan, nothing offered routinely — because nothing has been shown to save lives when used for screening.
And CA-125 is not a screening test. It is raised by endometriosis, fibroids, infection and even by having a period. Using it for reassurance in a woman with no symptoms causes more harm than it prevents.
Which means symptoms are the only early warning available, and that is why this page is mostly about recognising them.
The test is not what the symptoms are, but how they behave. New, persistent, and occurring most days for three weeks or more.
These symptoms overlap almost exactly with IBS. The distinction that matters: IBS rarely starts for the first time after 50.
A woman over 50 with new IBS-like symptoms should have ovarian cancer considered, not simply be given a diagnosis of IBS. That is UK guidance, and it is one of the commonest reasons for delay.
The combined contraceptive pill substantially reduces ovarian cancer risk, and the protection continues for years after stopping. That is a genuine benefit and it is rarely mentioned.
Pregnancy and breastfeeding also reduce risk.
NHS genetic testing and counselling is free and is the right route — not a commercial DNA test. A result affects your screening, your options, and your relatives, and it needs support around it.
Ask your GP for referral to genetics if you have several affected relatives, anyone diagnosed young, or a combination of breast and ovarian cancer in the family.
CA-125 blood test, followed by ultrasound of the abdomen and pelvis if it is raised — or ultrasound directly if the clinical picture warrants it.
CT scanning follows where cancer is suspected, and diagnosis is confirmed by biopsy or at surgery.
A protein raised in many ovarian cancers — and in a long list of harmless conditions. Endometriosis, fibroids, pelvic infection, liver disease and menstruation itself all raise it.
In premenopausal women a raised CA-125 usually means very little. It is considerably more informative after the menopause.
And it can be entirely normal in early ovarian cancer, so a normal result does not close the question if symptoms persist.
The point is that CA-125 is a test for symptomatic women, not a screening test for well ones. In someone with persistent bloating and early satiety it is a reasonable first step. In someone with no symptoms buying reassurance, it is not.
We cannot examine you, which matters here — abdominal and pelvic examination is part of the assessment.
We do not diagnose or treat ovarian cancer. That needs imaging, gynaecological oncology and surgery.
This is a condition where being properly listened to is the intervention. The symptoms are vague, they have usually been dismissed at least once, and the pattern only emerges if someone asks the right questions.
Note which days you have symptoms over three or four weeks. "Most days for a month" is a far more powerful thing to present than "I've been bloated lately", and it is difficult to dismiss.
A private GP generally cannot refer into the NHS urgent suspected cancer pathway. We write to your NHS GP the same day with the findings so that referral can be made.
Ask for a CA-125 blood test and an ultrasound, and ask for your symptoms to be recorded.
Go back. If symptoms have not settled with treatment, or you are over 50 and this started recently, that diagnosis deserves questioning rather than accepting.
Everyone gets bloated. What matters is bloating that is persistent, frequent and new for you.
Keeping a simple diary for three or four weeks is the most useful thing you can do — mark the days you have symptoms. A pattern on paper is far harder to dismiss than a description.
Ask about ovarian, breast, bowel and womb cancer on both sides of your family, and the ages people were diagnosed.
If there is a pattern, ask your GP about NHS genetic assessment. It is free, it comes with counselling, and it can lead to risk-reducing options that genuinely work.
There is no screening test, and no private panel changes that.
Paying for a CA-125 when you have no symptoms is more likely to cause harm than good — false positives lead to scans, anxiety and occasionally surgery in healthy women.
There is no screening test for ovarian cancer, and that is the most important thing on this page. The UK National Screening Committee does not recommend screening, following a large UK trial which found that screening with CA125 and ultrasound did not reduce deaths — while producing false alarms and unnecessary surgery.
Private “ovarian cancer screening” packages are sold despite this. We will not arrange one, and we would advise against buying one. CA125 is raised by endometriosis, fibroids, infection, menstruation and pregnancy, so in a well premenopausal woman it generates far more anxiety than information.
What works instead is symptom awareness, and it is free. Persistent bloating, feeling full quickly or loss of appetite, pelvic or abdominal pain, and needing to pass urine more often — occurring frequently, more than twelve times a month, and persisting. Those are the symptoms, they are vague, and taking them seriously is the whole strategy.
Where we add value is recognising that pattern and arranging CA125 and ultrasound promptly, or referring urgently — rather than another course of treatment for presumed IBS, which is the commonest way this is missed.
NHS care is free and is the right route for both investigation and treatment.
NICE CG122, Ovarian cancer: recognition and initial management, is the governing guideline. It recommends testing CA125 in women over 50 with symptoms suggesting IBS occurring for the first time, and in anyone with persistent bloating, early satiety, pelvic or abdominal pain, or urinary urgency occurring more than twelve times a month.
CG122 recommends ultrasound if CA125 is 35 IU/ml or greater, and calculation of the Risk of Malignancy Index.
CG122 is explicit that CA125 is not a screening test and is elevated in numerous benign conditions.
The UK National Screening Committee does not recommend population screening for ovarian cancer, following the UKCTOCS trial — the basis for the position above.
NICE NG12 covers urgent referral criteria, and NICE CG164 addresses familial risk, where BRCA testing and risk-reducing surgery are considered through NHS genetics services.
No — and this is the single most important thing on this page.
Nothing has been shown to reduce deaths when used to screen women without symptoms, which is why no programme exists.
That makes recognising symptoms the only early warning available.
If you have no symptoms, no — and we would say so rather than take the fee.
CA-125 is raised by endometriosis, fibroids, infection and even menstruation. In a well woman it produces false alarms that lead to scans and sometimes surgery.
If you have persistent symptoms, it is a reasonable first test — which is an entirely different situation.
Not necessarily. It can be normal in early ovarian cancer.
If your symptoms persist, they still need following up — a normal result narrows the question rather than closing it.
Three things: is it persistent, is it frequent, and is it new for you?
Bloating most days for three weeks or more, in a way you have not had before, is the pattern that warrants checking. Occasional bloating after a meal is not.
If you are over 50 and this started recently, it deserves questioning.
IBS rarely begins for the first time after 50, and UK guidance says ovarian cancer should be considered in that situation rather than an IBS label applied.
Go back and ask specifically for a CA-125 and an ultrasound.
No — the opposite. The combined pill substantially reduces ovarian cancer risk, and the protection lasts for years after stopping.
It is one of the clearer benefits of the pill and it is rarely mentioned.
No. Cervical screening checks the cervix only.
This is a very common misunderstanding, and it has led women to assume they have been checked when they have not. Cervical screening is still enormously worth having — it just answers a different question.
If there is a significant family history, it is worth asking about — through the NHS, free.
NHS genetics provides counselling before and after, which matters because a result affects your screening, your options and your relatives.
A commercial DNA test delivers that result with no support attached, and we would not recommend it.
Usually not — it is more often a womb lining problem — but it always needs investigating.
Postmenopausal bleeding is never normal, however light and however brief. See your GP and ask for an urgent referral.
August 30, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
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