Committee Opinion No. 477: the role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer.

Epithelial ovarian cancer is most commonly detected in an advanced stage, when the overall 5-year survival rate is 20–30%. Detection of early-stage ovarian cancer results in improved survival. Currently, there is no effective strategy for ovarian cancer screening. Women with persistent and progressive symptoms, such as an increase in bloating, pelvic or abdominal pain, or difficulty eating or feeling full quickly, should be evaluated, with ovarian cancer being included in the differential diagnosis. Evaluation of the symptomatic patient includes physical examination and may include transvaginal ultrasonography and measurement of levels of the serum tumor marker CA 125. Patients suspected of having ovarian cancer should be managed by a gynecologic surgeon, such as a gynecologic oncologist, who is trained to perform comprehensive surgical staging and cytoreductive (debulking) surgery.