When a woman experiences concerning symptoms, a pelvic exam, including a recto-vaginal exam, and a general physical exam should be performed. If the exam is abnormal, women should undergo a trans-vaginal or pelvic ultrasound to evaluate the ovaries.

If the exam is normal, it is reasonable to wait 2–3 weeks to see if the symptoms resolve. If they do not, then a trans-vaginal or pelvic ultrasound should be performed. If an abnormality of the ovaries is found, additional radiographic studies, such as a CT scan or MRI, and a blood test for CA 125, may be performed. CA 125 is elevated in approximately 80 percent of women with advanced stage epithelial ovarian cancer, but elevations can occur for reasons other than ovarian cancer.