Ovarian cancer (OvCa) is the 5th most deadly cancer for women in the US and is often referred to as a "silent killer" because it is frequently diagnosed at an advanced stage, resulting in a low five-year survival rate (<30%). However, if detected early, when the cancer is still confined to the ovaries (Stage I), the five-year survival rate can be as high as 90%. Unfortunately, OvCa is challenging to detect early with only 20% of cases caught in early stages as it rarely causes symptoms until advanced. No reliable, universally recommended, or effective screening test currently exists, which often leads to late-stage diagnosis (Stage III or IV). We are developing a screening test for OvCa, which consists of a novel integrated fluidic system for process automation, biomarkers specific to early OvCa onset, and the appropriate assay for producing high clinical figures-of-merit. The fluidic system consists of microfluidic modules made from plastics via injection molding that can be integrated to nanofluidic modules via a fluidic motherboard. The hardware for our tests can be mass produced at low-cost to facilitate bench-to-bedside transition and point-of-care testing (PoCT) that is typically required for large scale population screening. The assay uses liquid biopsy markers as the input, which can be secured in a minimally invasive manner appropriate for screening tests – for this OvCa application we are using extracellular vesicles (EVs). The screening test consists of a microfluidic module for EV affinity selection, which possesses a high density array of pillars surface-decorated with antibodies, to efficiently select EVs. This chip is integrated to a nanofluidic chip for the label-free enumeration of EVs to determine elevated levels of EVs in the plasma of patients suspected of having a specific type of OvCa, high grade serous OvCa (HGSOC). Unique EV-associated surface proteins were discovered for selection of HGSOC EVs specifically for the early detection of this disease – these markers consist of surface antigens associated with the fallopian tubes where the cancer originates. The selected EVs can be photolytically released from the capture surface and counted using a nano-Coulter Counter chip (nCC), which consists of two in-plane nanopores. The nCC can measure the size, particle density, and zeta potential of the OvCa-associated EVs. Both steps of the screening test described here are carried out using a microfluidic and nanofluidic chip integrated to a control motherboard for automating sample processing with results produced within 20 min. We will also discuss the use of exosomal microRNA as additional markers for enhancing the clinical figures-of-merit of the screening test.