Presentation and Evaluation of Ovarian Cancer

Ovarian Cancer is the third most common gynecologic malignancy worldwide and a leading cause of cancer-related mortality among women. According to Global Cancer Observatory 2022, it ranks fourth in global incidence among gynecologic cancers and second in gynecologic cancer-related deaths. In India, it is the second most common gynecologic malignancy. Despite a relatively modest lifetime risk(~1.1%), the disease carries a substantial population-level impact due to late-stage presentation in more than half of patients. Survival outcomes are stage- dependent, exceeding 90% in early disease but declining to nearly 30% in advanced stages. Risk factors include increased lifetime ovulatory cycles, nulliparity, and genetic predisposition, particularly BRCA1/2 mutations and Lynch syndrome. Epithelial ovarian cancers constitute about 90% of cases and include subtypes such as high-grade serous, endometrioid, clear-cell, and mucinous carcinomas, each with distinct molecular profiles. TP53 mutations are characteristic of high-grade serous carcinoma. Clinical presentation is often nonspecific, leading to delayed diagnosis. Evaluation includes serum biomarkers (CA-125, HE4) and imaging, with transvaginal ultrasonography as the first-line modality and O-RADS for risk stratification. Molecular testing for BRCA and homologous recombination deficiency is essential for therapeutic decision-making. Early detection and personalized management remain key to improving outcomes.