Ovarian cancer: Why it's hard to find and what to watch for

Ovarian cancer is often called a "silent" disease. The symptoms—bloating, pelvic discomfort, changes in appetite—overlap with a dozen everyday conditions. There's no standard population-level screening test. And by the time most people get a diagnosis, the disease has already advanced. More than 70% of cases are diagnosed once the cancer has spread beyond the ovaries, when treatment options are more limited and survival odds drop. But understanding how ovarian cancer develops, what signs to take seriously, and what role imaging plays gives you a clearer picture of your own risk—and what to do about it.

Key facts

• Around 21,000 new cases of ovarian cancer are estimated in 2026.
• More than 70% of cases are diagnosed once the cancer has spread.
• Five-year survival exceeds 90% when caught at Stage 1, but drops significantly in later stages.
• There's no USPSTF-recommended population-level screening program for ovarian cancer.
• High-risk groups include people with BRCA1 or BRCA2 mutations or a strong family history.

Understanding ovarian cancer

Ovarian cancer can affect anyone with ovaries. Having several risk factors doesn't guarantee you'll develop it, and being low-risk doesn't make you immune.

The main risk factors include:

• Age: risk increases after menopause
• Family history: direct relatives with ovarian or breast cancer
• Genetic factors: such as BRCA1 and BRCA2 mutations
• Lynch syndrome: a hereditary condition caused by mutations in mismatch repair genes, which increases the risk of ovarian, colorectal, endometrial, and other cancers
• Hormonal and reproductive history: long-term hormone replacement therapy use, endometriosis, and never having given birth are each associated with increased risk

Genetic testing can help identify people at higher risk and guide decisions about screening and risk-reduction strategies.

Why it's hard to catch early

No standard screening test

There's no standard population-level screening test for ovarian cancer—no equivalent of a mammogram or colonoscopy that's been proven to reduce mortality. The core problem is a mismatch: The disease is rare, silent, and biologically evasive, and every test tried so far has either missed too many cancers or falsely flagged too many healthy women.

Cancer antigen 125 (CA125) is a blood-based marker used in clinical settings, but it lacks specificity, meaning a positive result is far more likely to reflect something harmless than an actual tumor. Levels can rise for reasons unrelated to cancer, including benign conditions and normal hormonal changes. That limits its use as a standalone screener.

Transvaginal ultrasound is typically the first imaging tool used. It is widely available, relatively inexpensive, and safe, which is why it's favored as a first test, but it cannot always reliably distinguish benign from malignant lesions or detect every small, early-stage tumor.

Symptoms that are easy to dismiss

Symptoms don't make it easier. Symptoms like bloating, pelvic discomfort, and changes in appetite or urinary habits overlap with dozens of common, non-serious conditions. That makes it harder for both people and doctors to spot the signal in the noise.

That overlap is the core of the problem. Studies suggest the average time from symptom onset to diagnosis can be several months, partly because symptoms don't raise any alarms, and partly because there's no standard test to run when they do.

Why catching it earlier changes everything

When ovarian cancer is found at Stage 1, outcomes are dramatically different. The 5-year survival rate for Stage 1 ovarian cancer is almost 92%. Surgery tends to be less extensive. And where chemotherapy is needed, it's often less intensive, reducing the physical and emotional toll of treatment.

The earlier it's found, the more options you have.

What you can do

What a standard workup looks like

If you go to your doctor with persistent symptoms, the workup follows a fairly predictable path. Firstly, your doctor will likely order a CA125 blood test alongside a transvaginal ultrasound. Transvaginal ultrasounds are typically the first imaging step, giving a detailed image of the ovaries. This isn't something that Function currently provides access to; it's a clinical procedure ordered and interpreted by your doctor.

If results are abnormal or inconclusive, your doctor may refer you for further imaging, such as an MRI, or to a specialist for further evaluation.

Talk about it

Ovarian cancer symptoms are easy to dismiss—and that's part of what makes it so dangerous. Persistent bloating, pelvic pain, changes in appetite or urinary habits: These are worth taking seriously and worth talking about.

Know your risk

Understanding your personal risk—including family history, any relevant genetic variants, and your reproductive and hormonal history—is one of the most useful things you can do. If you have concerns, speaking to a doctor is a good first step.

Consider screening before symptoms

A clinical workup starts when symptoms appear. But you don't have to wait for symptoms to get a clearer look at what's going on in your body.

Function gives you access to 160+ yearly lab tests—covering hormones, inflammation, metabolic health, and more—reviewed by a licensed clinician and translated into plain language in your Clinician Notes. These aren't ovarian cancer diagnostic tests, but they give you a detailed view of your health and can surface patterns worth investigating further.

You can also add the Galleri® Multi-Cancer Test. In just one blood draw, it looks for cancer signals across 50+ types of cancer, including ovarian cancer, before they become symptomatic.

Function members can also access an Annual MRI that looks at your organs—including the ovaries—for signs of cancer and hundreds of other conditions. The MRI takes just ~22 minutes and is reviewed by a board-certified radiologist. Together, labs and MRI can give you a more complete view of your health that you can track over time.