What is the recommended referral pathway for a patient with suspected ovarian cancer in primary care?

In primary care, if a woman reports symptoms suggestive of ovarian cancer—such as persistent abdominal distension, feeling full, pelvic or abdominal pain, or increased urinary urgency or frequency—tests should be carried out, including measuring serum CA125, especially in women aged 50 or over ¹.

If serum CA125 is 35 IU/ml or greater, an ultrasound scan of the abdomen and pelvis should be arranged ¹.

If the ultrasound suggests ovarian cancer, the woman should be urgently referred using a suspected cancer pathway referral (for an appointment within 2 weeks) to a gynaecological cancer service ¹.

If serum CA125 is less than 35 IU/ml, or CA125 is 35 IU/ml or greater but ultrasound is normal, the woman should be assessed for other causes of her symptoms and investigated if appropriate. If no other cause is found, she should be advised to return if symptoms become more frequent or persistent ¹.