World Ovarian Cancer Day 2025: Know the signs and symptoms

Ovarian cancer is one of the most lethal cancer affecting females.

According to GLOBOCAN 2020 statistics, 1.6% of new cases and 2.1% of deaths of all sites are attributable to ovarian cancer.
It is the fourth most common cancer in Indian women with an incidence of 4.9 cases per 100,000. The crude mortality rate and age-standardized mortality rate of ovarian cancer are 2.3 and 2.02 per 100,000, respectively.

In about 90% cases, ovarian cancer is a sporadic event, and in only 5 to 10% cases there is a hereditary genetic mutation, especially in BRCA genes.

Since the symptoms are often vague and non-specific, majority of the patients are diagnosed in advanced stage (70%-80%), with poor long-term survival (15%-30%), compared with those with early-stage disease, where survival exceeds 80%.

Major trails done in the past have failed to show any survival benefit with routine screening.

• The US Preventive Services Task Force (USPSTF) 2018 recommendation statement continues to recommend against screening for ovarian cancer for asymptomatic women who are not known to have a high-risk hereditary cancer syndrome
• Patients identified with a high-risk family history should be referred to a genetic counselor and genetic screening for a possible hereditary cancer syndrome ( BRCA1, BRCA2, Lynch syndrome, and other mutations). Patients who test positive for one of these syndromes may benefit from interventions such as risk-reducing bilateral salpingo-oophorectomy

Symptom-triggered testing for ovarian cancer has been endorsed by various cancer organisations like American cancer society and Society of Gynecologic Oncology.

Though ovarian cancer was considered a silent killer, some symptoms if of new onset, coexistent with other symptoms, present almost daily for a few weeks and considered severe than expected, should be evaluated and can increase the chances of detecting disease in early stage

These include

 Bloating
 Abdominal or pelvic pain
 Difficulty in eating or feeling full quickly
 Urinary urgency or frequency

Symptoms usually precede the diagnosis by between 3 and 36 months

Studies have shown that with symptom based testing by CA125 and USG, 25% of high grade serous ovarian cancers can be detected at early stage or in advanced stage with a low volume disease burden more amenable to complete cytoreduction, thus improving the survival.

(By Dr. Vandana Jain, Senior Consultant and Head of the Department of Gynecologic Oncology at RGCIRC)