Ovarian Cancer Screening

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For Who?		By Whom?^b	How Often?
Empowerment
Women of all ages	Educate on: Risk factors, symptoms and signs of ovarian cancer Primary preventive measures for ovarian cancer (Table 1.)	Primary Healthcare Providers	Opportunistically
Assessment
Women of all ages	Assess: (1) Risk for Ovarian cancer Family history Ovarian/breast cancer Personal history of genetic mutation Deleterious gene mutations (e.g. BRCA1/2, Lynch syndrome) (2) Presence of signs and symptoms suggestive of Ovarian cancer:⁷ Abdominal mass Abdominal distention Abnormal vaginal bleeding Abdominal or pelvic pain Abdominal or pelvic bloating	Nurses Doctors	Opportunistically
Women with symptoms suggestive of ovarian cancer	Refer to seek early medical attention^#	^#Nurses	When symptomatic
	OR
	Provide work up assessment^	^Doctors
Screening
Asymptomatic Women at increased risk Strong family history of ovarian/breast cancer Inherited deleterious gene mutations (e.g. BRCA1/2, Lynch syndrome)	Discuss screening approach of ovarian cancer Refer to specialist as appropriate	Doctors	Opportunistically
Asymptomatic Women of average risk	Screening not recommended

1. Empowerment

a. For Who: Women of all ages

Recommended Care Components^a:

Educate on:

Risk factors, symptoms and signs of ovarian cancer
Primary preventive measures for ovarian cancer (Table 1.)

By Whom^b: Primary Healthcare Providers

How Often: Opportunistically

2. Assessment

a. For Who: Women of all ages

Recommended Care Components^a:

                                            Assess:

                                            (1) Risk for Ovarian cancer

                                            Family history
                                            Ovarian/breast cancer

                                            Personal history of genetic mutation
                                            Deleterious gene mutations (e.g. BRCA1/2, Lynch syndrome)

                                            (2) Presence of signs and symptoms suggestive of Ovarian cancer7
                                            Abdominal mass
Abdominal distention
Abnormal vaginal bleeding
Abdominal or pelvic pain
Abdominal or pelvic bloating

                                        

By Whom^b: Nurses / Doctors

How Often: Opportunistically

b. For Who: Women with symptoms suggestive of ovarian cancer

Recommended Care Components^a:

                                            Refer to seek early medical attention#

                                            OR

                                            Provide work up assessment^

By Whom^b: ^#Nurses / ^Doctors

How Often: When symptomatic

3. Screening

a. For Who: Asymptomatic Women at increased risk

Strong family history of ovarian/breast cancer
Inherited deleterious gene mutations (e.g. BRCA1/2, Lynch syndrome)

Recommended Care Components^a:

                                            Discuss screening approach of ovarian cancer
                                            
Refer to specialist as appropriate

By Whom^b: Doctors

How Often: Opportunistically

b. For Who: Asymptomatic Women of average risk

Recommended Care Components^a:

Screening not recommended

CA = Cancer Antigen; TVUS = Transvaginal Ultrasound

^a	Grade of recommendation according to colour code: Recommended (Strong) Conditionally recommended Practice points Generally not recommended Not recommended (Strong)

Primary Healthcare Providers – All providers of health services in primary healthcare settings
Primary Healthcare Professionals – Includes doctors, dentists, chinese medicine practitioners, nurses, pharmacists, physiotherapist, occupational therapist, dietitians
“Trained” Healthcare Professionals – Additional post-qualification training required to deliver the respective care component(s)

Table 1. CEWG Recommendation on Primary Preventive Measures for Ovarian Cancer⁴

Primary Prevention of Ovarian Cancer
	Certain ovarian cancer risk factors are modifiable and related to personal lifestyle and behaviour. Women can lower their risk of getting ovarian cancer by pursuing primary preventive measures below: *Maintaining a healthy body weight* by having regular physical activities and balanced diet *Avoiding or quitting smoking* *Following occupational safety and health rules* (e.g. proper use of personal protective equipment to reduce exposure to asbestos in the workplace) Breastfeed each child for a longer duration*

Primary Prevention of Ovarian Cancer

Certain ovarian cancer risk factors are modifiable and related to personal lifestyle and behaviour. Women can lower their risk of getting ovarian cancer by pursuing primary preventive measures below:

Maintaining a healthy body weight by having regular physical activities and balanced diet
Avoiding or quitting smoking
Following occupational safety and health rules (e.g. proper use of personal protective equipment to reduce exposure to asbestos in the workplace)
Breastfeed each child for a longer duration*

CEWG = Cancer Expert Working Group

*Breastfeeding was associated with lower risk of epithelial ovarian cancer, decreasing by 8% for every 5 months increase in breastfeeding duration⁸

Further Readings Reference Materials for Healthcare Professionals References