Diagnosing Ovarian Cancer

A new study has shown that many women diagnosed with ovarian cancer had complained of symptoms at least four months before their diagnosis but only about one quarter were given any diagnostic tests in a timely manner.

Ovarian cancer is considered a silent killer since it comes to the attention of a doctor only in its late stages, when prognosis is poor. Adding to this deadly pattern is the fact that it is a fast-growing tumor, often progressing from early to advanced disease in as little as a year. Lately, there has been increasing evidence that patients may exhibit symptoms many months before diagnosis and advanced disease occur, suggesting that earlier diagnosis is possible.

In the new study, women with ovarian cancer were found to be at least twice as likely to present to a doctor with abdominal swelling or pelvic pain as early as 12 months before diagnosis. As early as nine months before diagnosis, they were likely to complain of pelvic pain. About 40% had one or more doctor visits for symptoms between 36 and four months before diagnosis, but only 25% had diagnostic pelvic imaging or CA125 serum tests during that period. Most received abdominal imaging or diagnostic gastrointestinal studies, less likely to establish the correct diagnosis. In contrast, 54% of ovarian cancer patients received pelvic imaging or CA125 serum testing within three months before their ovarian cancer was diagnosed.

"Our findings suggest that ovarian cancer could be diagnosed earlier in some patients whose diagnosis is currently delayed by at least four months because physicians order abdominal imaging or perform gastrointestinal procedures before they order a test more likely to diagnose ovarian cancer, such as pelvic imaging and/or CA125,” concluded the authors of the study.

The study was conducted by Lloyd H. Smith, M.D., Ph.D., of the University of California at Davis School of Medicine (Sacramento, USA), and colleagues. They compared diagnosis codes and claims for diagnostic procedures among 1,985 elderly women with ovarian cancer, 6,024 elderly women with localized breast cancer, and 10,941 age-matched women without cancer. The results of the study were reported in the August 22, 2005, online issue of Cancer (Wiley InterScience).






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U. of California Davis School of Medicine