Distention, Not Bloating, Flags Ovary Ca


SANTA MONICA, CALIF. — Persistent abdominal distention, but not transient bloating, is associated with ovarian cancer, and clinicians should listen to their patients carefully to distinguish between the symptoms, according to a poster presentation by Dr. Clare R. Bankhead at the biennial meeting of the International Gynecologic Cancer Society.

Dr. Bankhead of the University of Oxford (England), and her colleagues conducted semistructured interviews with 124 women who were referred for evaluation of suspected ovarian malignancies. The investigators conducted a qualitative thematic analysis of the interviews to extract potential symptoms of ovarian cancer, and they conducted a multivariate quantitative analysis of the reported symptoms to determine which ones were associated with a diagnosis of ovarian cancer.

Of the 124 women, 44 were eventually diagnosed with malignancies. Forty of the malignancies were ovarian primary cancers (25 of which were at an advanced stage), two were peritoneal cancers, and the remaining two were gynecological cancers whose primary sites were unknown. Of the 80 women without cancer, 59 had benign gynecologic pathology and 21 had normal findings.

After adjusting for other symptoms, women with persistent abdominal distention with or without bloating were 5.2 times as likely to be diagnosed with ovarian cancer as women with neither bloating nor distention. This odds ratio was statistically significant.

Bloating alone, on the other hand, was not associated with an increased or decreased chance of being diagnosed with ovarian cancer.

Four other symptoms emerged in the multivariate analysis as being significantly associated with ovarian cancer diagnoses. They were early satiety (odds ratio 5.0), loss of appetite (odds ratio 3.2), postmenopausal bleeding (odds ratio 9.2), and progressive worsening of symptoms (odds ratio 3.6).

“The findings emphasize the need to listen carefully to women's accounts of abdominal symptoms,” the investigators wrote. “Clinicians should clarify whether women are describing bloating [fluctuating discomfort] or distention, and whether the symptoms are transient or persistent, in order to distinguish between them.”

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