Signs May Precede Ovarian Ca Diagnosis by Months


A study of California women with ovarian cancer showed that the patients had distinguishable symptoms at least 6 months before diagnosis, according to Lloyd H. Smith, M.D., Ph.D., chair of the department of ob.gyn. at the University of California, Davis, and his colleagues.

The researchers found that women with ovarian cancer more frequently reported abdominal pain and received abdominal imaging in the 7–9 months before their diagnosis, compared with women who had no cancer and those with early-stage breast cancer (Cancer [online]2005;DOI:10.10002/cncr.21310).

And some patients may have their diagnosis delayed by 4 months or more because physicians order abdominal imaging or perform gastrointestinal procedures before ordering pelvic imaging or CA 125 screening, which are more likely to diagnose ovarian cancer, the researchers reported.

The population-based, retrospective case-control study compared case reports from 1,985 women, aged 68 years or older with a diagnosis of ovarian cancer, with two control groups: 10,941 women with early-stage breast cancer and 6,024 randomly selected age-matched women with no diagnosis of cancer. Researchers used information from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and from Medicare Part B claims from women in California.

In the 1–3 months before diagnosis of ovarian cancer, 31% of women reported abdominal pain, 17% reported abdominal swelling, and 8% reported gastrointestinal symptoms.

Abdominal imaging and pelvic imaging/CA 125 screens were used frequently (70% and 54%, respectively) to investigate symptoms within 3 months prior to diagnosis of ovarian cancer. In the 4–36 months before their diagnosis, 61% of women with symptoms had abdominal imaging and 25% received pelvic imaging/CA 125 screening.

Although pelvic imaging and CA 125 screens are not recommended in asymptomatic patients, they could be “reasonable options for women who have target symptoms that are not explained by routine medical evaluation,” the researchers reported.

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