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Key indicators for ovarian cancer to aid GP diagnosis

Identifying a cluster of key indicator symptoms can help GPs to negotiate the minefield of ovarian cancer diagnosis, a new study suggests.

Symptoms that are especially severe, frequent and recent are 'more likely to be associated with ovarian masses', US researchers found.

Abdominal pain, pelvic pain, bloating, constipation and increased abdominal size were all particularly severe in women who had ovarian cancer, according to the study, published in the Journal of the American Medical Association (June).

And symptoms were occurring 15 to 30 times a month, compared with two to three times a month in women diagnosed with other conditions.

Researchers studied 1,700 women reporting to primary care clinics and compared the symptoms of women subsequently diagnosed with ovarian cancer with those who were not.

More recent onset of symptoms was also an important indicator. Women with ovarian cancer had been suffering from symptoms for an average of three to six months, compared with 12 to 24 months for other conditions.

The combination of bloating, increased abdominal size and urinary symptoms was found in 43 per cent of women with ovarian cancer and only 8 per cent of others.

Dr Trivadi Ganesan, head of the ovarian cancer group at the Cancer Research UK medical oncology unit in Oxford, said there were key messages to be taken from the study.

'If a GP in the UK has a patient with abdominal symptoms that are persistent, they should examine them very carefully,' said Dr Ganesan, who is a medical oncologist

at John Radcliffe Hospital in Oxford.

'There's no easy solution but we have to keep an index of suspicion and take a good history and do a careful internal examination.'

Dr Pawan Randev, a GP in Amersham, Buckinghamshire, and chair of the cancer primary care working group, said ovarian cancer was extremely difficult to diagnose.

He added: 'The results from this study show an interesting way of looking at diagnosing ovarian cancer.'

Updated guidance on referral for suspected cancers is due to be published by NICE early next year.

By Emma Wilkinson

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