Symptoms of Early Ovarian Cancer Not Adequately Screened

Cancer Connect

According to a recent publication in the journal Cancer, many women who are diagnosed with ovarian cancer were aware of symptoms of the disease between 3 years and 4 months prior to diagnosis. However, these women were not referred to appropriate testing. Since ovarian cancer is highly aggressive, this time lapse may affect a patients survival. These results were also published in an early online-only edition of Cancer.

Ovarian cancer is a malignancy that forms in cells within the ovaries. Approximately 25,000 new cases of ovarian cancer are diagnosed in the US each year.

Once ovarian cancer has spread from its site of origin, cure rates are very low with standard treatment. Symptoms of ovarian cancer are often vague, so the majority of cases are not detected until the disease has already spread. Signs of the disease may include abdominal swelling or bloating, abdominal or pelvic discomfort, diarrhea, or constipation.

These symptoms are frequently ignored since they tend to be mild in early stages of the disease. Furthermore, due to the nature of these symptoms, physicians often prescribe testing for gastrointestinal disorders, rather than ovarian cancer. Thus, the cancer is generally detected once its too advanced to cure. Since cure rates falling dramatically as disease advances, a patients best chance of long-term survival is with early detection and treatment.

Researchers from the University of California in Sacramento evaluated data including nearly 20,000 women. Nearly 2,000 of the women were diagnosed with ovarian cancer, over 6,000 had been diagnosed with early breast cancer, and nearly 11,000 had no cancer. Diagnosis codes and claims for diagnostic procedures were compared in these elderly, Medicare-enrolled women.

According to results, symptoms of ovarian cancer were widely prevalent, yet just a fraction of the women were screened for the disease:

  • Only approximately one-quarter of women who complained to their physician of abdominal pain or swelling underwent testing for ovarian cancer in a timely manner.
  • As early as one year prior to a diagnosis of ovarian cancer, patients diagnosed with the disease were twice as likely to complain to their physicians of abdominal swelling or pelvic pain.
  • As early as 9 months prior to a diagnosis of ovarian cancer, patients with the disease were much more likely to complain of abdominal pain.
  • Three years to 4 months prior to diagnosis of ovarian cancer, 40% of patients diagnosed with the disease had at least one or two visits to their physician because of abdominal or pelvic symptoms, such as bloating or pain.
  • Only 25% of these patients underwent testing specific for ovarian cancer (pelvic imaging or blood tests for the CA125 marker) in that time period.

The researchers concluded that testing for ovarian cancer is significantly delayed in patients with symptoms indicative of ovarian cancer. Unfortunately, since these symptoms are not limited to ovarian cancer, many patients undergo abdominal imaging or gastrointestinal procedures instead of pelvic imaging or testing for CA125. Patients who are experiencing vague or severe, but abnormal abdominal or pelvic bloating, swelling, pain, or diarrhea or constipation should speak with their physician regarding their individual risks and benefits of screening for ovarian cancer. Early detection and treatment are a necessary part of achieving long-term survival.

Reference: Smith LH, Morris C, Yasmeen S, et al. Ovarian Cancer: Can We Make the Clinical Diagnosis Earlier? Cancer. 2005; 204:1398-1407

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Ovarian Cancer