The Family Health Guide

Certain symptoms may be early signs of ovarian cancer

Ovarian cancer has long been called a "silent killer," because symptoms are thought to develop only after the disease has reached an advanced stage and is largely incurable. But health experts have identified a set of physical complaints that often occur in women who have ovarian cancer and may be early warning signs. These symptoms are very common, and most women with them do not have ovarian cancer. But for the women who do, the hope is that greater awareness will lead to earlier diagnosis and treatment.

In June 2007, the Gynecologic Cancer Foundation, the Society of Gynecologic Oncologists, and the American Cancer Society issued a consensus statement highlighting four symptoms that are more likely to occur in women with ovarian cancer than in women in the general population. These symptoms are bloating or increased abdominal size; pelvic or abdominal pain; difficulty eating or feeling full quickly; and urinary frequency or urgency.

The statement recommends that any woman who experiences one or more of these complaints almost daily for more than a few weeks should see a clinician for a thorough pelvic exam. Pelvic exams that raise suspicions are usually followed up with a noninvasive test called transvaginal ultrasound and possibly a blood test for a marker called CA-125, which is sometimes elevated in women with ovarian cancer. The only way to diagnose ovarian cancer is during surgery, which is best performed by a gynecologic oncologist or other surgeon skilled in ovarian cancer.

Research has shown that many women who have ovarian cancer complained about symptoms well before they were diagnosed, but their concerns were either ignored or attributed to something else. But if such symptoms are new, persist for several weeks, and get worse with time, they may be a sign of ovarian cancer. See below for further information on factors that affect risk of ovarian cancer.

What factors affect ovarian cancer risk?




Risk rises with age; average age at diagnosis is 65.

Birth control pills

Taking them for at least five years lowers ovarian cancer risk. (While taking them, risk for breast cancer, heart disease, and stroke increases, though these risk levels return to normal after discontinuing oral contraception.)

Number of births

Giving birth to fewer than two children increases ovarian cancer risk (and risk of breast cancer).


Doing so for at least a year (cumulative over all pregnancies) lowers ovarian cancer risk.


Lowers ovarian cancer risk (with or without oophorectomy).

Tied fallopian tubes

Lowers risk for ovarian cancer.

Family history/gene mutation

Having a mother, sister, or daughter diagnosed with ovarian cancer, especially at a young age, raises risk, as does having a mutation of the breast cancer genes BRCA1 and BRCA2.

It's estimated that more than 22,000 women in the United States will be diagnosed with ovarian cancer in 2007, and over 15,000 will die of the disease. Unlike cancers of the lung, colon, and breast, there is no good screening test for ovarian cancer. Although it's unclear whether recognizing these warning signs will lead to better outcomes, cancer experts and advocacy groups suggest that greater awareness of them may be the best hope for earlier diagnosis and improved survival.

October 2007 update