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Ovarian cancer is not often diagnosed in its early stages because it presents so few symptoms, or presents symptoms that are attributed to other conditions. There are few standard screening tests for ovarian cancer. However, the first tests a woman would probably experience to diagnose ovarian cancers include:

• Transvaginal ultrasound. An ultrasound test that is performed with an instrument placed inside the vagina. Transvaginal sonography can find a mass in an ovary, and may be able to detect if the mass is malignant (cancerous) or benign (noncancerous).
  
  
• Tumor marker tests. A tumor marker is a substance that can be detected in elevated amounts in the urine, blood or body tissue of some individuals with certain cancers. Women at risk of developing ovarian cancer may have a tumor marker blood test that measures the patient’s CA-125 (also called OC-125) level. Elevated levels of this protein are often present in women with ovarian cancer. However, other noncancerous diseases of the ovaries and some cancers of other organs may also increase CA-125 level. Some ovarian cancers may not produce enough of the protein to register a positive test result. When CA-125 results are positive, further testing may be necessary to determine if cancer exists. This test is typically recommended only for women with strong risk factors, and even then there is much doubt about its usefulness.
  

• Imaging studies. These tests cannot confirm that a mass is cancerous. However, they may be useful in determining if a mass is indeed present and if a cancer has spread to other parts of the body. Common imaging studies for ovarian cancer include:
  
  
• • Ultrasound. During an ultrasound, a small probe is placed on a patient’s abdomen or inside the vagina (transvaginal). Ultrasound may be useful in identifying tumors because healthy ovarian tissue and tumors reflect sound waves differently. This test may also be helpful in determining whether a tumor is solid (more likely to be malignant) or fluid-filled (more likely to be benign).
    
    
  • CAT scan (computed axial tomography). This test allows for multiple x-rays to be taken from different angles around the patient. The cross-sectional images of the patient’s body are analyzed by a computer. This test gives the treatment team information about the size of a tumor and may help  identify enlarged lymph nodes that may be cancerous.
    
    
  • Chest x-ray. This test allows the physician to determine if the cancer has spread to the lungs.
    
    
• Other tests. The following tests may also be performed:
  
  
• • Laparoscopic examination. During this procedure, the physician inserts a slender, lighted tube through an incision in the patient’s abdomen and examines the ovaries and other pelvic organs as well as tissue near the bile duct. This procedure provides a view of the patient’s organs that can help the physician plan surgery or other treatments. It can also help the physician confirm the stage of the cancer. Additionally, laparoscopy allows physicians to manipulate small instruments through the patient’s incision to perform a biopsy for microscopic examination.
    
    
  • Biopsy. The only way for a physician to be certain that a growth in the pelvic region is cancerous is to surgically remove a tissue sample for microscopic analysis. This is called a biopsy. In patients with fluid accumulation inside their abdomen (ascites), cancer may also be diagnosed with fluid samples. Biopsies are typically performed surgically, with a goal of obtaining samples of tissue for diagnosis and staging (determining the extent of the cancer). Cancer deposits that exceed half an inch (1 centimeter) may be surgically removed during a biopsy.
    
    CAT scans also can be used to accurately guide a needle into a possible metastasis. This procedure is called a CAT-guided needle biopsy. During the CAT-guided needle biopsy, the patient remains on the CAT table while a radiologist inserts the biopsy needle into the mass. CAT scans are repeated until the medical team is certain the needle is in the correct place. A biopsy sample is then removed and examined with a microscope.

If ovarian cancer is diagnosed, other tests may be performed to see if cancer has spread into other parts of the pelvic region or other parts of the body.