New age-based blood test thresholds recommended by NICE will help GPs catch ovarian cancer earlier
More women with ovarian cancer could be diagnosed earlier under proposed new NICE guidance that replaces a one-size-fits-all blood test threshold with personalised, age-based criteria.
Around 1 in 50 women will develop ovarian cancer in their lifetime, with around 7,000 women diagnosed each year in the UK. The disease is often caught late because symptoms such as bloating, abdominal pain and feeling full quickly can be vague and overlap with other conditions.
A draft update to our guideline on suspected cancer proposes new thresholds for the CA125 blood test that reflect how ovarian cancer risk changes as women get older.
A CA125 blood test measures levels of a protein in blood, which are often elevated in cases of ovarian cancer, and can be used for monitoring existing cancer or guiding further investigation.
Currently, all women are referred for further investigation if their CA125 level reaches 35 IU/ml or above, regardless of age. This fixed threshold can miss cancers in older women while triggering unnecessary investigations in younger women.
The guideline also recognises that for women under 40, CA125 testing alone is not sufficiently accurate to guide decisions. For this group, GPs should consider arranging an ultrasound scan directly for those with persistent symptoms.
The committee’s proposed recommendations will ensure more personalised, targeted testing, so women at greatest risk of ovarian cancer are identified and referred sooner.
This tailored approach will mean GPs can make more informed decisions about which patients need urgent investigation, while reducing unnecessary ultrasound scans, freeing up NHS resources.
These updates will ensure that our guideline reflects the latest evidence and will help improve the detection of cancer and ensure those who need it get swift treatment.
The updated guideline also proposes:
A new age threshold so that people aged 60 and over with unexplained weight loss (greater than 5% over six months) receive an urgent investigation or suspected cancer pathway referral.
With hormone replacement therapy (HRT) prescriptions in England rising the guideline acknowledges a growing need for clearer evidence on when unexpected bleeding while taking HRT should prompt investigation for endometrial cancer. NICE’s guideline committee has recommended that research is undertaken to fill this gap and help clinicians make better-informed decisions.
GPs and other primary care professionals use the NICE guidance to decide when patients with potential cancer symptoms should be referred to specialists. The suspected cancer guideline covers multiple cancer types, helping primary care professionals identify the 143,000 people diagnosed with cancer in England each year.
The public consultation on the draft recommendations runs until Monday, 2 February 2026. Comments can be submitted via nice.org.uk.