Ms. Li’s face was full of sorrow when she walked into the clinic. She is 61 years old, her son and daughter have already started a family, and she should be enjoying the happiness with her family, but she was hit by a bolt from the blue. A few months ago, Ms. Li felt bloated and could not eat. She thought she was tired from bringing up her grandchildren and didn’t pay much attention to it, and her neighbors said she had lost a lot of weight. Her son took her to the gastroenterology department and did many tests, but no abnormalities were found. The doctor prescribed her several boxes of medication, which did not have any effect after taking them. In the last week her stomach became more distended, and she also had back pain and abdominal pain. One day before going to bed she rubbed her belly and suddenly found a hard lump inside. This time an alarm was sounded in her heart and she came to the hospital the next day. Gynecological ultrasound showed a mass on the left side of the pelvis with indistinct margins and irregular morphology, and blood flow signals were visible in the solid part. It was also combined with a large amount of ascites and an elevated serum CA125 value. After comprehensive clinical signs and the above examination results, ovarian cancer was initially considered. After detailed analysis and discussion, we finally decided to perform a cesarean section after completing the relevant auxiliary examinations. Postoperatively, pathology confirmed that the cancer was ovarian epithelial cancer stage IIIC, with metastases in the pelvic and abdominal cavities, including the greater omentum, subtransverse septum and mesentery. After surgery, Ms. Li also needed to receive at least 6 cycles of chemotherapy. What Ms. Li did not understand was why she had “stomach disease” a few months ago, but became “advanced tumor” a few months later. If the disease had been detected at the first visit, wouldn’t there have been more hope for a cure? As we all know, ovarian cancer, endometrial cancer and cervical cancer are known as the three major malignant tumors in gynecology, which are also known as the three major killers of women’s health. Among them, the incidence rate of ovarian cancer is the lowest, but the mortality rate is the highest, and its 5-year survival rate is only about 30%. In the past decade, the incidence of ovarian cancer in China has been on the rise and gradually tends to be younger. Ovarian cancer can develop in women of any age, mostly in perimenopausal women, and it is rare in patients under 20 years old. On the one hand, the risk factors are reproductive factors. People who have not yet given birth, have early menarche or late menopause have an increased number of ovulations in their lifetime and are at higher risk of ovarian cancer. On the other hand, the role of genetic factors in the development of ovarian cancer is the most definite, and more and more studies have confirmed the association of ovarian cancer with genetic factors. There is evidence that people with first-degree relatives who have ovarian cancer have a 5% increased risk of developing ovarian cancer. Other high-risk factors include hormone replacement therapy, high-fat diet, and obesity. The early symptoms of ovarian cancer are not obvious, and patients are often at an advanced stage when they present with symptoms and seek medical attention. Early stage ovarian cancer is often combined with gastrointestinal symptoms, such as abdominal distension and loss of appetite, while abdominal pain is often not obvious. Some patients may have edema of the vulva and lower limbs, or changes in menstrual cycle. As the disease progresses, the tumor gradually increases in size and the symptoms become more and more obvious. Patients with advanced ovarian cancer often have a combination of ascites, abdominal bulge, and hard masses on palpation. Patients rapidly lose weight, become weak, and even develop cachexia. The enlarged tumor may cause obvious compression symptoms: compression of nerves may cause pain in the lower back and abdomen; compression of bladder may cause difficulty in urination; compression of rectum may cause constipation or difficulty in defecation. The main treatment method of ovarian cancer is the combination of surgery plus chemotherapy, supplemented by radiotherapy and adjuvant therapy such as Chinese medicine. Its prognosis is closely related to factors such as stage, surgical satisfaction and patient’s sensitivity to chemotherapy drugs. The 5-year survival rate after surgery for early-stage ovarian cancer can reach 70%-90%, while the 5-year survival rate for advanced-stage patients is less than 30%. Thus, early detection of ovarian cancer can significantly improve the prognosis of patients, so how to achieve early detection? At present, there is still a lack of effective screening means and early diagnosis methods for ovarian cancer worldwide, and most of the early stage patients are unintentionally discovered during physical examination or benign tumor surgery. Currently, there are two main screening indicators, one is glycoantigen CA125, which is an indicator of ovarian epithelial cancer, but its sensitivity is high and specificity is poor, and it can also be elevated in non-ovarian malignant tumors, endometriosis, thoracic ascites and other diseases, and 50% of patients with early-stage ovarian cancer can have CA125 without elevation. The other is transvaginal ultrasound (TVS), which can measure the volume of ovaries more accurately and non-invasively, and has been widely used in recent years. However, due to the limitations of ultrasound itself, it cannot distinguish between benign and malignant tumors, cannot detect lesions of normal ovarian size, and is highly subjective, with a high false-positive rate and poor specificity as a screening tool. Combining the characteristics of the two screening methods, some scholars have proposed the combined application of the two methods for the early screening of ovarian cancer. Currently, a phase large clinical study on the combination of CA125 and TVS for ovarian cancer screening is underway in the UK, and the results will be published later this year, which hopefully will bring good news. The cause of ovarian cancer is still unknown, so there are no primary prevention measures. For people with genetic risk factors, preventive removal of the ovaries may be considered to avoid cancer. In addition, some studies have confirmed that oral contraceptives have a protective effect on the ovaries and can reduce the incidence of ovarian cancer. For the majority of women comrades, they should have regular checkups, establish a positive mindset and lifestyle habits, and eat more calcium-rich foods such as milk, shrimp, and soy products. For perimenopausal women, if there is unexplained abdominal distension and wasting, especially for patients with ascites, if there is no abnormality in gastrointestinal examination, further gynecological ultrasound should be performed to exclude the occurrence of ovarian cancer and avoid delaying the best treatment time.