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Maple Grove Blog

Screening Guidelines for Ovarian and Cervical Cancer

Monday, January 23, 2012 at 12:15 pm by Sarah Manneh, MD


As an obstetrics and gynecology doctor, I approach my care for women from the perspective of ‘women’s advocate or voice in health and wellness’. Disease prevention is frequent topic with all my patients, including knowing when to talk with me about abnormal gynecological or ‘down there’ symptoms that might be a sign something more serious. Gynecological conditions that include ovarian and cervical cancers require ongoing patient attention because the symptoms can be ‘silent’ until the disease is more advanced.

With the New Year and renewed resolutions for good health, I encourage women of any age to know the screening guidelines for ovarian and cervical cancers and talk with their provider about risk.

Ovarian cancer symptoms and risk factors
Ovarian cancer is often referred to as the ‘silent killer’ because many of the symptoms can be blamed on something else or are undetectable until the cancer is more advanced. Symptoms include stomach bloating (puffiness), pelvic or abdominal pain, urinary symptoms, and feeling full quickly.

There are several risk factors for ovarian cancer. Ask yourself the following questions. If you answer "Yes" to more than two questions, discuss your risk for ovarian cancer with your provider.

  • Are you 55 years or older? 
  • Have you experienced infertility (unable to become pregnant)? 
  • If yes, did you use assistive reproductive technologies to help you become pregnant? 
  • Have you experienced endometriosis? (a condition in which tissue from the inside of the uterus grows outside of the uterus) 
  • Have you used hormone replacement therapy? (hormones pre- or post-change-of-life) 
  • Do you have a personal or family history of cancer? 
  • Is your BMI (body mass index) greater than 30? 
  • Is your family of Eastern European or Ashkenazi Jewish heritage?


Ovarian screening recommendations
Unfortunately, there are no screening tests for ovarian cancer. Annual pelvic exams will help to detect cancer and give women good reason to visit their doctor every year. Yearly ultrasounds and blood work are not recommended as routine screenings and are used only to help confirm a diagnosis of cancer. If a patient has a strong ovarian and breast cancer history in the family, BRCA1 and BRCA2 genetic testing is offered. If a woman has an ovarian mass, two blood tests, OVA1 and CA-125, can help to determine if it is cancer.



Cervical cancer
It’s good news that the rates of cervical cancer, particularly advanced stages, continue to fall because of cervical cancer screening. The Pap smear is the universal standard of gynecologic care for detection of cervical cancer and annual pelvic exams and pap smears are recommended for all women, particularly in those who are sexually active.



Cervical cancer symptoms and risk factors
Risk factors linked with cervical cancer include having sex at an early age, a greater number of lifetime sexual partners, and a history of sexually transmitted diseases, including the human papillomavirus (HPV) infection. A history of smoking, age, immune function, and nutritional status are also important to consider.


Cervical cancer screening guidelines: talk with your provider
The American Cancer Society (ACS) recommends starting cervical cancer screening three years after sexual activity begins but no later than age 21. Annual screenings with conventional Pap tests are recommended until age 30 and after age 30, screening every two to four years is advised based on risk factors and past screening results.

The American College of Obstetrics and Gynecology (ACOG) recommends annual screening begin at age 21 regardless sexual activity. Further, ACOG suggests screening earlier than 21 may be unnecessary and could lead to harmful evaluations in women who are at low risk. Screening in women aged 21 to 29 is recommended every two years and in women aged 30 and older, who have a history of three negative results, should be tested every three years.

To determine what is best for you, I recommend you talk with your provider about your risk factors.


There are trusted resources that offer helpful information and include:

American College of Obstetrics and Gynecology (ACOG)

Minnesota Ovarian Cancer Alliance (MOCA)

American Cancer Society


Sarah Manneh, MD, Oakdale Obstetrics and Gynecology



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