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Overview

Ovarian cancer begins in the ovaries, fallopian tubes or closely related tissues, while endometrial cancer develops in the inner lining of the uterus. According to GLOBOCAN 2022 estimates, India recorded approximately 47,000 new ovarian cancer cases and 17,000 cancers of the uterine body.

End-O Check is a risk-based early detection program from Apollo Cancer Centres for ovarian and endometrial cancers. It combines specialist consultation, individual risk assessment and transvaginal ultrasound, with further investigations recommended only when clinically required.

There is currently no routine screening test proven to reduce ovarian cancer deaths among women at average risk. Similarly, routine screening for endometrial cancer is not recommended for asymptomatic women at average risk. End-O Check is therefore intended to support personalised risk assessment, recognition of warning signs and timely evaluation rather than population-wide screening.

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Why Screening Is Important

Ovarian cancer may initially cause vague symptoms, while abnormal vaginal bleeding; particularly after menopause; is often an early warning sign of endometrial cancer. Risk-based evaluation can:

  • Identify women at increased risk: Personal, reproductive and family history can help determine whether further assessment or genetic counselling is appropriate.

  • Support timely evaluation: Persistent bloating, pelvic discomfort or abnormal vaginal bleeding can be investigated without avoidable delay.

  • Detect abnormalities requiring follow-up: Ultrasound may identify changes in the uterus, endometrium or ovaries that need further assessment.

  • Guide personalised monitoring: Women with hereditary cancer syndromes or other important risk factors can receive an individualised follow-up plan.

  • Improve awareness: Women learn which symptoms require medical attention and should not be dismissed as normal hormonal or age-related changes.

A normal examination or ultrasound cannot completely rule out ovarian or endometrial cancer. New or persistent symptoms should always be evaluated.

Why Screening Is Important
Why Screening Is Important Ovarian Cancer
Works

How It Works

Following a consultation and risk assessment, the doctor may perform a pelvic examination and recommend a transvaginal ultrasound. During the ultrasound, a slender probe is gently placed inside the vagina to obtain detailed images of the uterus, endometrial lining and ovaries. If an abnormality is detected, further evaluation may include blood tests, additional imaging, hysteroscopy or an endometrial biopsy, depending on the findings and the cancer suspected.

Who Should Be Evaluated

Women

Women aged 45 years and above

Women with a family history of ovarian, endometrial, breast, colorectal or pancreatic cancer

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Women with BRCA1, BRCA2, Lynch syndrome or Cowden syndrome-related genetic variants

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Women with obesity, diabetes, PCOS or endometriosis

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Women with a history of infertility or no previous pregnancies

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Women who experienced early menstruation or late menopause

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Women taking tamoxifen or certain forms of hormone replacement therapy

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Women with postmenopausal bleeding, abnormal vaginal bleeding or persistent pelvic or abdominal symptoms

Your Screening Journey at Apollo Cancer Centres

  • Registration
  • Risk assessment and consultation
  • Transvaginal ultrasound
  • Results and next steps
  • Follow-up or additional tests, if recommended
Your Screening Journey at Apollo Cancer Centres
Your Screening Journey at Apollo Cancer Centres Ovarian Cancer

Advantages of Endometrial & Ovarian Screening at ACC

Individualised Risk Assessment

Individualised Risk Assessment

A specialist reviews the woman’s symptoms, medical history, reproductive history and family history before recommending investigations.
Targeted Evaluation

Targeted Evaluation

Transvaginal ultrasound and additional tests are advised according to individual risk and clinical findings.
Genetic Risk Evaluation

Genetic Risk Evaluation

Women whose personal or family history suggests a hereditary cancer syndrome can be referred for genetic counselling and, when appropriate, genetic testing.
Coordinated Follow-up

Coordinated Follow-up

Abnormal findings are evaluated through an appropriate pathway that may include imaging, biopsy, hysteroscopy or specialist review.
Comprehensive Cancer Care

Comprehensive Cancer Care

If cancer is confirmed, patients have access to multidisciplinary treatment planning and personalised gynaecological cancer care.
Frequently Asked Questions
01 What is End-O Check?
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End-O Check is a risk-based early detection program for ovarian and endometrial cancers. It combines specialist consultation, risk assessment and transvaginal ultrasound, with further tests recommended when clinically necessary.
02 Is End-O Check a routine screening test for every woman?
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No. There is no standard population-wide screening test for ovarian or endometrial cancer in asymptomatic women at average risk. End-O Check is intended to identify individual risk, evaluate symptoms and guide appropriate investigations.
03 Who should consider End-O Check?
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Women aged 45 years and above may consider an individual risk assessment, particularly if they have obesity, PCOS, diabetes, endometriosis, infertility or an important family history. Women with symptoms or hereditary risk may require evaluation at a younger age.
04 I do not have symptoms. Should I still undergo evaluation?
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If you have an important family history, a known hereditary cancer syndrome or another significant risk factor, an assessment may be appropriate even without symptoms. For women at average risk, routine ovarian or endometrial cancer screening has not been shown to improve outcomes.
05 What is a transvaginal ultrasound?
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A transvaginal ultrasound uses sound waves to produce images of the uterus, endometrial lining and ovaries. A slender ultrasound probe is gently inserted into the vagina during the examination.
06 Is transvaginal ultrasound painful?
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Most women experience no pain or only mild, temporary discomfort. Tell the clinician if you experience pain or feel anxious about the examination.
07 Can transvaginal ultrasound detect ovarian cancer?
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It can identify an ovarian cyst, mass or other abnormality, but it cannot determine by itself whether a finding is cancerous. Further assessment may be required.
08 Is CA-125 a screening test for ovarian cancer?
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CA-125 is not recommended as a routine screening test for women at average risk. It may be elevated in ovarian cancer, but it can also rise due to several non-cancerous conditions and may remain normal in some cancers. Doctors use it selectively alongside clinical findings and imaging.
09 What happens if an ovarian cyst or mass is detected?
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Most ovarian cysts and masses are not cancerous. The doctor will assess factors such as your age, menopausal status and the size and appearance of the mass before recommending monitoring, blood tests, further imaging or surgery.
10 How is endometrial cancer diagnosed?
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If endometrial cancer is suspected because of abnormal bleeding or ultrasound findings, an endometrial biopsy may be performed to collect a tissue sample. Hysteroscopy with biopsy or dilation and curettage may be required if the initial sample is insufficient or further evaluation is needed.
11 Is postmenopausal bleeding normal?
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No. Any vaginal bleeding or spotting after menopause should be medically evaluated, even if it happens only once or the amount is small.
12 Does a Pap test detect ovarian or endometrial cancer?
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No. A Pap test is primarily used to screen for cervical cancer. It does not reliably screen for ovarian or endometrial cancer, although endometrial abnormalities may occasionally be detected incidentally.
13 I have a family history of cancer. Do I need genetic testing?
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Not everyone with a family history requires genetic testing. A specialist or genetic counsellor can review which relatives were affected, their ages at diagnosis and the types of cancer involved before advising whether testing is appropriate.
14 How often should End-O Check be repeated?
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There is no single schedule suitable for every woman. Follow-up should be based on symptoms, risk factors, hereditary cancer status and previous findings. Annual ultrasound is not routinely recommended for all women at average risk.
15 What happens if an abnormality is detected?
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An abnormal result does not necessarily mean that you have cancer. Depending on the finding, the doctor may recommend repeat imaging, blood tests, an endometrial biopsy, hysteroscopy, genetic evaluation or consultation with a gynaecological oncologist.