Ovarian cancer

Ovarian cancer is the 5th most common malignancy in females in the UK accounting for 4275 deaths per year. Five thousand new cases are diagnosed each year – an incidence of 20.3 per 100 000 of the population.

Ovarian carcinoma accounts for a quarter of all genital tract cancer but is responsible for more than half the deaths, primarily due to its late presentation.

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Who to refer, who not to refer, how to refer

Who to refer:

All patients with USS suspicious of ovarian malignancy and/or elevated CA125 level should be referred as USOC to gynaecology

Please ensure patients have USS prior to referral and CA125 pending or completed.

For patients who have a simple cyst identified on USS please see RefHelp guidelines on Pre Menopausal Cysts – RefHelp (nhslothian.scot) and Post Menopausal Cysts – RefHelp (nhslothian.scot).

Who not to refer:

Do not refer without prior pelvic USS and CA 125. A new pelvic mass on clinical examination may represent benign disease (e.g. fibroids) in some women.

How to refer:

Sci-Gateway > RIE or SJH> Gynaecology> Ovarian Pathology>USOC

Primary care management

Please perform abdominal and pelvic examination on all women suspected of having ovarian cancer
Organise urgent pelvic USS
Measure CA125 (not during menstruation if possible)

Resources and links

NICE clinical guideline CG122. Ovarian cancer: recognition and initial management: https://www.nice.org.uk/guidance/cg122

British Gynaecological Cancer Society (BGCS) Epithelial Ovarian / Fallopian Tube / Primary Peritoneal Cancer Guidelines: Recommendations for Practice https://www.bgcs.org.uk/wp-content/uploads/2019/05/BGCS-Guidelines-Ovarian-Guidelines-2017.pdf

Scottish cancer referral guidelines: http://www.cancerreferral.scot.nhs.uk/

Last reviewed: 24/07/2025

Next review date: 24/07/2027

Author(s): Faye Rodger.

Author email(s): obsandgynae.mailbox@borders.scot.nhs.uk .