Some 15% of women with ovarian cancer die within two months of diagnosis. With 7,000 women diagnosed annually, this equates to approximately 1,000 women a year. Late diagnosis is a major cause of low survival rates for ovarian cancer patients in the UK, compared to other countries so as a notoriously difficult disease to diagnose and treat, we GPs need to acknowledge the vital role of primary care on the frontline.
Among key barriers to early diagnosis is the lack of awareness of the symptoms of ovarian cancer among women and health professionals. The symptoms of ovarian cancer can be vague and will often be misdiagnosed as another benign ailment, like IBS for example.
However, this means a third of women will wait six months or more from having first visited their GP before getting a correct diagnosis.
The wide regional variation in one-year survival rates for women with ovarian cancer shows that there are pockets of excellent practice which may in part be due to better access to diagnostics. We need to push for Public Health England to provide data on regional variations on short term mortality; important evidence for greater and more targeted intervention to improve early diagnosis, and also an opportunity to share best practice with the regions that are saving lives.
There is a pressing need to improve the low levels of awareness of ovarian cancer symptoms in women in the general population, via a nationally-led symptoms campaign, such as Be Clear on Cancer.
And there is a pressing need for all GPs to recognise and respond promptly to women with symptoms in order to reduce the number of women diagnosed as a result of admission to A&E. Tools such as Target Ovarian Cancer’s free online GP training modules and symptoms flag pens are there to support GPs in making this happen.
We need to ensure that GPs are fully resourced. Target Ovarian Cancer’s new GP advisory board is committed to supporting GPs, most recently discussing the urgent need to address regional variations in GPs’ access to diagnostic tests.
GPs also need to be fully supported in knowing that appropriate requests for test referrals won’t be questioned or refused, wherever they are in the UK. The Advisory Board’s aims are to support the effectiveness of GPs in diagnosing ovarian cancer, through enhancing best practice and in making the most of existing support available.
No GP wants to miss a diagnosis of ovarian cancer and a strong foundation of knowledge of the disease will help us identify patients most at risk, for early referral and investigations. Let’s strive to make it a priority in our surgeries to rule out ovarian cancer – and save lives.
Professor Nigel Sparrow, chairman of Target Ovarian Cancer’s GP advisory board, senior national GP advisor and responsible officer at the CQC, and medical director for revalidation at the RCGP.