I’ve spent my career working around medical devices and cancer detection, and I’ve seen and worked on the advances. New therapies, precision medicine, AI, better imaging, and earlier detection.
But there’s one women’s cancer where reliable screening is missing: ovarian cancer.
Mammograms exist to detect breast cancer. Pap smears exist to catch cervical cancer. Colonoscopies and stool-based tests exist to screen for colon cancer. But there’s still no recommended routine screening for ovarian cancer in asymptomatic women at average risk. There isn’t a standard blood test that reliably finds ovarian cancer early enough for population screening. And no screening strategy has yet been shown to reduce ovarian cancer mortality.
The Cost of Finding It Late
In the U.S. alone, the American Cancer Society estimates 21,010 women will be diagnosed with ovarian cancer in 2026, and nearly 12,450 of those women will die from it. That’s a mortality rate close to 60%. The global picture is worse. There were 324,603 cases in 2022.
Ovarian cancer is a very different disease when it’s found early. Invasive epithelial ovarian cancer is the most common type, with a five-year survival rate close to 92% when it’s localized. That drops to 32% when the cancer is diagnosed after it’s spread. Most women are diagnosed after it’s already spread because there’s no test built to catch it earlier.
That gap doesn’t prove that screening will save lives. A screening strategy needs to find cancers early enough to change outcomes, but early detection of ovarian cancer is one of the hardest in cancer diagnostics.
Why the Test Doesn’t Exist Yet
Part of the challenge with ovarian cancer is that symptoms can be nonspecific. Bloating, pelvic or abdominal pain, feeling full quickly and changes in urination are symptoms women experience for countless reasons.
It’s not reasonable to expect women to distinguish everyday bloating from an early malignancy. Physicians can’t biopsy every woman who experiences abdominal pain. Healthcare systems shouldn’t treat every common symptom as cancer. This is why diagnostics matter.
But biology makes this hard. Roughly 90% of ovarian cancers are epithelial, meaning they start in the tissue. Evidence indicates that most high-grade serous tumors originate in the fallopian tubes, not the ovary itself.
That changes how we need to think about early detection. The challenge may not be simply finding a smaller mass on an ovary. It may mean identifying molecular or biological evidence of the disease before conventional imaging has anything to detect. That’s a harder problem to solve than breast or colorectal screening ever was, and exactly the kind of challenge medical innovation exists to solve.
Women’s Health Needs a Diagnostics Moonshot
Part of why this gap has persisted for so long is women’s health research has never been funded like the problem it is. Today, only 9–11 percent of U.S. medical research funding targets conditions specific to women, despite women representing half the population. And breast cancer research received nearly four times more funding from NIH than ovarian cancer research in 2025. That kind of underinvestment is exactly why a problem as hard as ovarian cancer screening has gone unsolved for this long.
Women’s health is finally attracting serious attention, and that attention needs to translate into real R&D for ovarian cancer across biomarkers, proteomics, genomics, liquid biopsy, imaging, AI, and longitudinal patient data. The eventual answer probably isn’t one test. It’s more likely a diagnostic pathway: genetic and family-history risk stratification to identify who needs closer monitoring, longitudinal biomarkers tracked over time rather than a single blood draw (the way PSA velocity works in prostate cancer), and imaging and algorithms layered on top to determine who needs further evaluation.
We also need diagnostic development that reflects how women actually interact with healthcare. A breakthrough that requires expensive equipment available only at major academic medical centers is scientifically meaningful, but it isn’t sufficient.
I’ve spent much of my career working around medical devices and cancer detection, and one lesson keeps repeating itself: a technology doesn’t improve an outcome merely because it exists. It has to reach the patient. That’s part of the reason why I founded HERhealthEQ, to bring discarded but fully functional medical equipment to the underserved areas that need it. The goal should be an early-detection pathway that reaches women across geography, income, and healthcare systems, the kind that gets into a primary care visit in Nairobi or São Paulo as readily as Boston.
This Is What an Unmet Need Actually Looks Like
Healthcare uses the phrase “unmet need” constantly, in conference panels and product strategies, and it’s begun to lose its meaning. Ovarian cancer gives the phrase its meaning back. Women develop this cancer every year knowing that modern medicine still can’t offer a reliable way to screen for it before symptoms appear. We should find that unacceptable, because difficult diagnostic problems are exactly where our best science and technology should be going.
Women’s health is finally moving closer to the center of scientific and policy conversations. Technologies that were experimental a decade ago are becoming clinically useful across imaging, molecular diagnostics, computation, and biology. Now we need to decide which problems deserve that momentum, and ovarian cancer should be one of them.
We’ve spent decades getting better at treating cancer after we find it. But with ovarian cancer, we need to get better at finding it in the first place.