RISK FACTORS, SIGNS & SYMPTOMS & INVESTIGATIONS & DIAGNOSIS
RISK FACTORS
Increased risk:
- Increasing age
- Family history of ovarian/breast cancer
- Endometriosis
- BRCA1/2 gene mutations
- White ethnicity
- Early menarche
- Late menopause
- HRT use
Decreased risk:
Multiple pregnancies
COCP use
- Breastfeeding
SIGNS & SYMPTOMS
Red flags (if >12 times/month):
- Daily bloating
- Pelvic/abdominal pain
- Increased urinary frequency/urgency
- Weight loss
- Malaise
- Fatigue
- Changes in bowel habits
INVESTIGATIONS & DIAGNOSIS
If normal examination:
- CA125 test
- If CA125 ≥35 IU: urgent ultrasound
- If ultrasound positive: 2-week wait referral
- If CA125 is abnormal but the ultrasound is normal: review if symptoms persist/worsen
If an abnormal examination:
- Direct 2-week wait for referral if pelvic/abdominal/cystic mass present (non-fibroid)
- CA125 not required
TREATMENT PLAN
- 2-week wait referral pathway if indicated.