Why Isn’t There Ovarian Cancer Screening in the UK? (And Should You Have Annual Scans?)

By /

Ovarian cancer is one of the most feared gynaecological cancers, and understandably so. My own nana died of ovarian cancer when I was 6, and it has shaped every decision I have made since. Sadly it is still often diagnosed at a later stage because symptoms can be vague. This leaves many women (including me) wondering:

“Why can’t I just have a yearly blood test or scan to catch it early?”

It’s a completely reasonable question, and one I have asked myself on repeat.

In this article, I’ll walk you through:

  • Why there is no ovarian cancer screening programme in the UK
  • Whether CA125 blood tests and ultrasound scans are effective
  • When testing may be appropriate
  • What you can realistically do to protect your health

Why Is There No Ovarian Cancer Screening Programme in the UK?

For a screening programme to be introduced on the NHS, it must:

  • Detect disease early
  • Reduce deaths
  • Do more good than harm

The UK conducted one of the largest studies ever on ovarian cancer screening: the UKCTOCS.

This trial followed over 200,000 women and used:

  • Annual CA125 blood tests
  • Annual transvaginal ultrasound scans
  • Or no screening

The results were clear:

Screening did not significantly reduce deaths from ovarian cancer.

While more early-stage cancers were detected, this did not translate into improved survival overall.

Screening also led to:

  • False positive results
  • Unnecessary surgeries
  • Surgical complications
  • Increased anxiety and repeat testing

Because of this, ovarian cancer screening does not meet the criteria for a national programme.

What Is CA125, and Why Isn’t It Reliable?

CA125 is a blood test that can be raised in ovarian cancer.

However, it is not specific.

It can also be elevated in:

  • Endometriosis
  • Fibroids
  • Pelvic infections
  • Pregnancy
  • Even normal menstruation

And crucially:

  • It can be normal in early ovarian cancer

This means:

👉 A raised CA125 does not necessarily mean cancer
👉 A normal CA125 does not rule it out

This makes it unsuitable as a population screening test.

Are Ultrasound Scans Helpful?

Transvaginal ultrasound is an excellent diagnostic tool when symptoms are present.

However, when used for screening in women without symptoms, it often finds:

  • Benign ovarian cysts
  • Normal physiological changes
  • Incidental findings that would never cause harm

This can lead to:

  • Repeat scans
  • Ongoing anxiety
  • Unnecessary surgery

A good screening test should improve outcomes, not simply detect more abnormalities.

Should You Have Annual Ovarian Cancer Screening Privately?

This is where things become more nuanced.

1. High-Risk Women

Women with genetic mutations such as:

  • BRCA1
  • BRCA2

Or a strong family history may be offered:

  • Regular monitoring
  • Genetic counselling
  • Discussion of risk-reducing surgery

Even in this group, screening is not perfect, but it is more justified.

2. Informed Private Surveillance

Some women choose annual testing for reassurance.

This can be appropriate if done with full understanding, including:

  • The risk of false positives
  • The possibility of unnecessary surgery
  • The limitations of CA125
  • The risk of false reassurance

It should be framed as:

“Ovarian surveillance with recognised limitations”

—not as guaranteed early detection.

3. Symptom-Based Testing (Most Important)

This is where the strongest evidence lies.

Guidance supports testing when symptoms are present.

Key symptoms include:

  • Persistent bloating
  • Feeling full quickly (early satiety)
  • Pelvic or abdominal pain
  • Post-menopausal bleeding
  • Sudden urgency to pass urine, recurrent UTIs or passing urine a lot more than usual

Especially if symptoms are:

  • New
  • Frequent (more than 12 times per month)
  • Persistent

If these occur, investigation should not be delayed.

Why Is Ovarian Cancer So Difficult to Screen For?

Ovarian cancer presents unique challenges:

  • It may begin in the fallopian tubes
  • It can spread early
  • Symptoms are often vague
  • There is no reliable early biomarker

At present, we do not have a test that consistently detects ovarian cancer early enough to reduce mortality at a population level.

What Can You Do Instead?

If you are at average risk:

  • Be aware of symptoms
  • Seek medical advice if symptoms persist
  • Ensure your family history is documented
  • Attend routine cervical and breast screening

If you are at higher risk:

  • Consider genetic counselling
  • Discuss personalised risk assessment
  • Seek specialist input

If you feel anxious:

  • A personalised consultation can help you understand your individual risk and options

Reputable Resources

If you would like to learn more, these trusted organisations provide excellent, evidence-based information:

Final Thoughts

It is completely understandable to want reassurance when it comes to ovarian cancer.

However:

Annual scans and CA125 blood tests have not been shown to reduce deaths from ovarian cancer.

That’s why there is no NHS screening programme.

But this does not mean there is nothing you can do.

The most important steps are:

  • Understanding your body
  • Recognising persistent symptoms
  • Seeking timely medical advice
  • Knowing your individual risk

If you would like a personalised women’s health or cancer risk review, you can book an appointment here: https://www.thefemalehealthdoctor.com/womens-cancer-screening-services-milton-keynes/

Scroll to Top
Verified by MonsterInsights