Ovarian, Fallopian Tube & Peritoneal Cancer Screening

Ovarian, fallopian tube, and primary peritoneal cancers are diseases in which malignant (cancer) cells form in the ovaries, fallopian tubes, or peritoneum.

The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries produce eggs and female hormones (chemicals that control the way certain cells or organs function).

The fallopian tubes are a pair of long, slender tubes, one on each side of the uterus. Eggs pass from the ovaries, through the fallopian tubes, to the uterus. Cancer sometimes begins at the end of the fallopian tube near the ovary and spreads to the ovary.

The peritoneum is the tissue that lines the abdominal wall and covers organs in the abdomen. Primary peritoneal cancer is cancer that forms in the peritoneum and has not spread there from another part of the body. Cancer sometimes begins in the peritoneum and spreads to the ovary.

Ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer form in the same type of tissue. Studies of screening tests look at these cancers together.

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Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium.

For more information about ovarian, fallopian tube, and primary peritoneal cancers, see the following:

• Ovarian, Fallopian Tube, and Primary Peritoneal Cancers Prevention
• Genetics of Breast and Gynecologic Cancers
• Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancers Treatment
• Ovarian Germ Cell Tumors Treatment
• Ovarian Low Malignant Potential Tumors Treatment

In the United States, ovarian cancer is the fifth leading cause of cancer death in women.

While ovarian cancer is rare, it is the leading cause of death from cancer of the female reproductive system. The number of new cases of ovarian cancer decreased slightly each year from 1990 to the mid-2010s, but increased slightly each year from 2014 to 2018. There was a slight decrease in the number of deaths from ovarian cancer each year from 2015 to 2019.

Different factors increase or decrease the risk of getting ovarian, fallopian tube, and primary peritoneal cancers.

Anything that increases your chance of getting a disease is called a risk factor. Anything that decreases your chance of getting a disease is called a protective factor.

For information about risk factors and protective factors for ovarian cancer, see Ovarian, Fallopian Tube, and Primary Peritoneal Cancers Prevention.

Talk to your doctor about your risk of ovarian cancer.

Tests are used to screen for different types of cancer when a person does not have symptoms.

Scientists study screening tests to find those with the fewest harms and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) helps a person live longer or decreases a person's chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.

Screening tests have not been shown to decrease the chance of dying from ovarian cancer.

Screening tests that have been studied include:

Pelvic exam

Pelvic exams to screen for ovarian cancer have not been shown to decrease the number of deaths from the disease. A pelvic exam is an exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. A speculum is inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. The doctor or nurse also inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.

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Pelvic exam. A doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand. This is done to feel the size, shape, and position of the uterus and ovaries. The vagina, cervix, fallopian tubes, and rectum are also checked.

Transvaginal ultrasound

Transvaginal ultrasound (TVU) to screen for ovarian cancer has not been shown to decrease the number of deaths from the disease. TVU is a procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An ultrasound transducer (probe) is inserted into the vagina and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

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Transvaginal ultrasound. An ultrasound probe connected to a computer is inserted into the vagina and is gently moved to show different organs. The probe bounces sound waves off internal organs and tissues to make echoes that form a sonogram (computer picture).

Studies have also shown that using CA-125 levels and TVU together to screen for ovarian cancer does not decrease the number of deaths from ovarian cancer.

Screening tests for ovarian, fallopian tube, and primary peritoneal cancers are being studied in clinical trials.

Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

Screening tests have risks.

Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to talk about the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.

The risks of ovarian, fallopian tube, and primary peritoneal cancers screening tests include the following:

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PDQ® Screening and Prevention Editorial Board. PDQ Ovarian, Fallopian Tube, and Primary Peritoneal Cancers Screening. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/ovarian/patient/ovarian-screening-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389490]

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