Abdominal swelling and pain are common symptoms that occur before ovarian cancer is diagnosed. Researchers from the University of California at Davis, Sacramento, USA found that some patients with ovarian cancer report symptoms many months before their ultimate diagnosis while some ovarian cancer patients might have earlier diagnosis if pelvic imaging is included in their workup. Ovarian cancer is generally thought of as a silent disease, because it doesn't cause severe symptoms until it has reached an advanced stage. The new findings suggest that it might give rise to certain complaints at an earlier stage as well. The researchers used the data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program and from medicare claims for California women who developed ovarian cancer to investigate whether symptoms preceded a diagnosis of ovarian cancer and whether an earlier clinical diagnosis is possible in patients with ovarian cancer. Data for 1985 women with ovarian cancer, 10,941 with breast cancer and 6024 control subjects without cancer were included in the analysis. Abdominal swelling and pain were significantly more common six months prior to diagnosis in the women with ovarian cancer than among women in the non-cancer and breast cancer groups. Gastrointestinal symptoms and pelvic pain were also more common among women diagnosed with ovarian cancer than among women in the two control groups, 1-3 months before the diagnosis. The findings suggest that ovarian cancer could be diagnosed earlier in some patients whose diagnosis is currently delayed by at least 4 months, because physicians order abdominal imaging or perform gastrointestinal procedures before they order a test that is more likely to diagnose ovarian cancer. If routine medical evaluation fails to explain the symptoms and they persist, then testing for ovarian cancer should be considered. But as is true for many diagnostic tests in the setting of symptom evaluation, many patients may have a negative test.
Cancer,
August 2005