Although ovarian cancer has been p...

Although ovarian cancer has been pondering to be asymptomatic until the late stages of the disease, late studies have indicated that women with ovarian cancer reported symptoms before diagnosis, and these symptoms are similar for late and early disease stages. The greatest in number common complaints reported before diagnosis have included abdominal, gastrointestinal tract, pain, constitutional, urinary, and pelvic symtoms. Given that five-year survival for ovarian cancer is a great deal higher with early diagnosis, a reliable risk of symptoms to look for might facilitate early detection. Goff and colleagues performed a inquiry of primary care patients to determine whether the commonness severity, and duration of symptoms were more pronounced in women with ovarian cancer than in those seen for routine problems

The authors scaned women visiting two primary care sites regarding the severity, common occurrence and duration of 20 symptoms associated with ovarian cancer. The same review was given to women presenting at a specialty clinic for removal of an ovarian or pelvic mass.

Of the 1709 patients who complet the view 25 percent were presenting for a general checkup, 13 percent were there for a mammogram, and 62 percent were being seen for specific puzzles Of these women, 95 percent had at least individual of the 20 listed symptoms in the previous year, with back pain reported principally commonly (60 percent), then fatigue (52 percent) indigestion (37 percent) urinary tract symptoms (35 percent) constipation (33 percent) and abdominal pain (28 percent) Many of the symptoms recurr at least monthly in 72 percent of the women Symptoms were in the greatest degree common in women with diabetes, thyroid disease, and irritable bowel syndrome (IBS). Postmenopausal women had fewer symptoms overall than premenopausal women As age increased, all symptoms were les usual except for urinary tract symptoms.

Of the 128 women with a pelvic mass, 84 had benign masses and 44 had malignancies, 11 with early stage disease and 33 with advanced disease. Women with malignancies had a higher median number of symptoms and recurring symptoms than the clinic patients, with 36 percent having had symptoms for brace months or less, 24 percent having symptoms for pair to three months, and 14 percent having symptoms longer than single year. When comparing women who had malignancy with women who had IBS (and, therefore, had high numbers of symptoms), a significantly higher percentage of women with malignancy had pelvic pain (41 versus 25 percent) bloating (70 versus 49 percent) increased abdominal size (64 versus 32 percent) and urinary tract symptoms (55 versus 33 percent) Women with ovarian cancer were significantly more likely than the clinic collection to have pelvic pain, abdominal pain, difficulty eating, bloating, increased abdominal size, and urinary urgency

In comparing disposes of symptoms, 43 percent of women with ovarian cancer had the combination of bloating, abdominal pain, and urinary tract symptoms, whereas 10 percent of women with benign masses, 13 percent of women with IBS, and 8 percent of clinic women had this combination. Symptoms were more methodical and more frequent in women with ovarian cancer or IBS than in clinic patients. Symptoms typically were continuous in women with malignancies, compared with occasional and intermittent symptoms in clinic patients. Women with benign masses also frequently had daily symptoms, which overlapped with the symptoms experienced by the agency of women with ovarian cancer, if it be not that included constipation. Finally, women with ovarian cancer had a a great deal of shorter duration of symptoms at a median of six month or les compared with 12 to 24 month in clinic patients and those with IBS.

No effective screening example exists for ovarian cancer. The symptoms greatest in quantity commonly reported in patients with ovarian cancer include bloating, increased abdominal size, abdominal or pelvic pain, and urinary tract symptoms, although these also are used by all in women with benign masses. Symptoms be attendant to be more severe, more visit often and of shorter duration in women with malignant masses than in women with benign masses. Women with ovarian cancer also are more likely to not absent with a combination of symptoms.

The authors close that this study provides more evidence that ovarian cancer is not an asymptomatic disease. Symptoms that are more unadorned more frequent, and of new onset are more likely to be associated with ovarian masses.

Goff BA, et al. frequent occurrence of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA June 9 2004;291:2705-12

COPYRIGHT 2005 American Academy of Family Physicians

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