Ovarian cancer remains one of the few major cancers without a standard screening test. Most cases are diagnosed in later stages, when treatment options narrow and survival rates drop.
The biology behind the problem
Dr. Annie Leung, a gynecologic oncologist, explained that the name “ovarian cancer” is misleading. Most cases don’t start in the ovary. Instead, they begin in the fallopian tubes, which release cells that spread through the abdomen.
Dr. Lucy Gilbert, chief of gynecological cancer services at McGill University Health Centre, described how the fallopian tubes have soft, finger-like structures. Cancer starting there flakes off like dust and moves into the abdomen. The cells drift freely because the tubes aren’t anchored, allowing the disease to spread before detection.
By the time imaging or blood tests identify the cancer, it has usually advanced beyond the ovaries. As many as 80 per cent of all ovarian cancers are diagnosed in either stages three or four, making treatment difficult. Tani Vrionis, CEO of Ovarian Cancer Canada, noted that women often face recurrence at this point.
Why current tests fall short
Blood-based early detection tests work for cancers like breast or colorectal because those tumors release cells into the bloodstream early. Ovarian cancer doesn’t follow the same pattern. The peritoneal cavity is sealed by a thin membrane, trapping cancer cells until they’ve spread.
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Ultrasounds are also out because the tiny cellular development of cancer in the fallopian tubes is difficult to detect.
The CA125 blood test checks for a protein that rises in ovarian cancer but isn’t reliable. The protein can increase due to endometriosis or menstruation, leading to false alarms.
The issue stems from decades of underfunding. While other cancers saw screening breakthroughs, ovarian cancer research received less attention. Vrionis acknowledged the gap, saying efforts are now accelerating to close it.
For families watching a loved one decline, the lack of progress feels like neglect. The disease spreads silently, microscopic and invisible, until it’s too late to intervene.
Funding and research must match the urgency of the disease. Without progress, late diagnoses and limited options will continue, leaving families questioning why the warning signs went unnoticed. Medical training programs could help professionals recognize symptoms earlier, but broader systemic changes are needed.
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