Ovarian Cancer: Recognize the Signs, Reduce the Risk, and Respond Early

By Dr. Priya Thakur Dubey, MBBS, DNB (OB GYN), DGO, MRCOG-1

Ovarian cancer is one of the leading causes of cancer-related death among Indian women, with a projected incidence of 49,644 cases reported in 2025. It often goes unnoticed in early stages because symptoms can be subtle. Yet, it’s a serious illness: each year, over 300,000 women worldwide are diagnosed with ovarian cancer. Despite these alarming statistics, growing awareness and medical advancements are offering renewed hope. This article delves into the early detection of ovarian cancer, highlighting key warning signs, risk factors, available treatments, a patient’s journey, and proactive steps for prevention and awareness.

What is Ovarian Cancer?

Ovarian cancer is a type of cancer that begins in the ovaries. The female reproductive glands that produce eggs and hormones such as estrogen and progesterone. It occurs when abnormal cells in the ovary grow and multiply uncontrollably, forming a tumor. If left undetected or untreated, it can spread to other parts of the body. Ovarian cancer is not just one disease, but rather a group of diseases categorized into different types based on the kind of cells where the cancer starts, with epithelial ovarian cancer being the most common. Understanding the nature of this disease is essential because early detection significantly improves outcomes.

By the Numbers: Key Statistics

To recap some important statistics about ovarian cancer:

● Incidence: Ovarian cancer is relatively uncommon but not rare. Globally, over 300,000 new cases were estimated in 2022. It ranks lower in incidence compared to breast or lung cancer but remains the 8th most common cancer in women worldwide.

● Mortality: Ovarian cancer is the deadliest gynecologic cancer because so many cases are diagnosed late. Worldwide, it caused approximately 207,000 deaths in 2022.

● Lifetime Risk: For the average woman, the chance of getting ovarian cancer in her lifetime is roughly 1 in 90 (about 1%). The chance of dying from it is about 1 in 140. These odds increase with risk factors like genetic mutations.

● Survival Rates: The stage at diagnosis makes a huge difference. About 20% of ovarian cancers are found at an early localized stage. The 5-year survival for these early cases is over 90%. Unfortunately, around 3 out of 4 cases are diagnosed after the cancer has spread. The overall 5-year relative survival is about 50–51%. For regional spread, it’s around 70%; for distant spread, about 30%. These numbers are gradually improving with better treatments.

It’s worth noting that statistics are just numbers – each person’s case is unique. Survival rates can’t predict exactly what will happen with any one individual, but they underscore the importance of early detection and effective treatment.

Detecting Ovarian Cancer Early

Early detection remains one of the biggest challenges related to ovarian cancer.

There is no reliable way to screen for ovarian cancer in asymptomatic women, according to the U.S. Centers for Disease Control. The Pap test (which checks for cervical cancer) does not screen for ovarian cancer.

This means that, unlike some other cancers, there isn’t an effective standard test to diagnose ovarian cancer at an early stage in women.

To detect it early, physicians rely on close attention to symptoms and risk factors. If there are concerning signs or a woman is at high risk, doctors may use diagnostic tests, for example, a pelvic exam, transvaginal ultrasound, or a blood test for the tumor marker CA-125, to investigate. These tests can sometimes help detect ovarian tumors when symptoms are present, but they are not used as routine screening.

High-risk women (such as those with certain genetic mutations) are often counselled about preventive options, which might include closer monitoring or even preventive surgery.

It’s important to recognize that early-stage ovarian cancer is difficult to detect. Only about 1 in 5 cases of ovarian cancer is found at an early, localized stage. Early tumors often don’t cause noticeable issues, or the symptoms are vague and are attributed to more common ailments. Many women are diagnosed only once the disease has already spread.

Why does early detection matter? 

Early detection matters because the survival rates are significantly higher when ovarian cancer is diagnosed early. When confined to the ovaries (localized), the 5-year survival rate is over 90%. By contrast, if it has spread to distant organs, 5-year survival drops to around 30%.

Early Symptoms to Watch For

Ovarian cancer’s early symptoms are often subtle, but there are a few patterns women can watch for:

● Bloating: Persistent abdominal bloating or swelling that isn’t normal for you.
● Pelvic or abdominal pain: Discomfort, pressure, or pain in the lower abdomen or pelvic area.
● Feeling full quickly or difficulty eating: Early satiety or loss of appetite.
● Frequent or urgent urination: Needing to urinate more often or feeling urgency, even when the bladder isn’t full.

These symptoms tend to be persistent and represent a change from one’s normal state. They are not just occasional or fleeting discomforts. Other possible symptoms include unexplained back pain, fatigue, indigestion, or changes in bowel habits like constipation.

It’s crucial to note that these issues can also be caused by benign conditions. However, what’s important is newness, frequency, and duration. If you have a new symptom, occurs almost daily for more than a couple of weeks and has no obvious explanation, it’s wise to get it checked out. Don’t panic – most of the time it won’t be ovarian cancer – but it’s important to rule out serious causes.

Also, any abnormal vaginal bleeding – especially after menopause – warrants prompt medical evaluation.

Who Is More Prone to Ovarian Cancer?

Not everyone has the same risk. Researchers have identified several factors that increase the likelihood:

● Age: Most cases occur in women over 50 years of age, with the highest incidences in those aged 63 and above. The risk increases with age.

● Family History & Genetics: A family history of ovarian cancer (mother, sister, daughter) raises your risk. Inherited mutations in genes like BRCA1 and BRCA2 significantly increase risk. Lynch syndrome also raises the risk. Women of Ashkenazi Jewish descent are more likely to carry BRCA mutations.

● Reproductive History & Hormonal Factors: Women who never had a full-term pregnancy, had early menstruation, or late menopause have an increased risk. Endometriosis also raises risk, while pregnancy and breastfeeding lower it slightly.

● Lifestyle Factors: Obesity and long-term hormone replacement therapy (especially estrogen-only for over 10 years) may increase the risk. Smoking is not a major factor, but it can contribute to rarer ovarian cancers.

● Other Factors: Many women diagnosed with ovarian cancer do not usually have high-risk factors. However, if you do have a strong family history or genetic predisposition, genetic counselling and testing can be beneficial.

To put things in perspective: the average woman’s lifetime risk is about 1–1.3%. For those with BRCA mutations or family history, the risk is significantly higher.

Stay tuned for Part 2 of this article, where we’ll cover treatment, prevention, and awareness strategies in depth.

References:

1. World Health Organization (WHO)
World Health Organization. “Cancer.” Accessed May 7, 2025. https://www.who.int/health-topics/cancer.

2. National Comprehensive Cancer Network (NCCN)
National Comprehensive Cancer Network. “Home.” Accessed May 7, 2025. https://www.nccn.org/.

3. American Cancer Society
American Cancer Society. “Home.” Accessed May 7, 2025. https://www.cancer.org/.

4. Surveillance, Epidemiology, and End Results Program (SEER)
National Cancer Institute. “SEER: Surveillance, Epidemiology, and End Results Program.” Accessed May 7, 2025. https://seer.cancer.gov/.

_MSM/DP