'Traditional primary care skills' key to spotting ovarian cancer, GPs told
By Mark Pownall
GPs' ‘traditional primary care skills' are the best hope for diagnosing ovarian cancer earlier when it can be successfully treated, primary care research has found.
A study published in the BMJ this week found the difficulties is diagnosing ovarian cancer is often compounded by the fact that women commonly report a number of symptoms in the months before they are diagnosed.
Researchers found seven symptoms were statistically linked to later ovarian cancer diagnosis (see box), and 85% of the patients diagnosed with ovarian cancer had at least one of them – but so did 15% of the controls.
The study compared symptoms presenting to general practice in 212 women who had a diagnosis of primary ovarian cancer, with 1,060 controls matched by age and general practice.
Three of the symptoms – abdominal distension, urinary frequency and abdominal pain – were linked to later development of ovarian cancer even if they occurred more than six months before diagnosis.
But the seven symptoms identified in the study, carried out in 38 general practices in Devon, are common in the ‘healthy' population, with many other causes, and with poor predictive power.
Dr William Hamilton, lead researcher and consultant senior lecturer at the University of Bristol, said: ‘There is some chance of identifying early ovarian cancer by using symptoms. In particular abdominal distension is a common important symptom and warrants rapid investigation.'
‘Other symptoms require more traditional primary care skills: history taking, examination, and considering the possibility of cancer.'
In an accompanying commentary, Oxfordshire GP Dr Robin Fox said that patients with symptoms may benefit from further investigation with ultrasound and a CA125 test while waiting for referral to a gynaecologist.