Abstract

Objective: To recognise and measure ovarian cancer signs in women receiving primary care.

Design: Case-control research that included the primary care records of the participants for the year prior to diagnosis.

Setting: Devon, England has 39 general practitioners.

Participants: 212 women over 40 had an initial ovarian cancer diagnosis between 2000 and 2007; 1060 controls with similar age and general practise.

Main outcome measures: From conditional logistic regression analysis, odds ratios and positive predictive values for symptoms.

Results: In a multivariate study, seven symptoms were linked to ovarian cancer. There were 2.5 percent (1.2 percent to 5.9 percent) and 240 (46 to 1200) for abdominal distension, 0.5 percent (0.2 percent to 0.9 percent) and 24 (9.3 to 64) for postmenopausal bleeding, 0.6 percent (0.3 percent to 1.0 percent) and 17 (6.1 to 50) for loss of appetite, and 0.2 percent (0.1 percent to 0.3 percent) and 16 (5.6 to 48) for increased urogenital flow, respectively. At least one of these seven symptoms was reported to primary care prior to diagnosis in 181 (85%) cases and 164 (15%) controls. Abdominal distension, frequent urination, and abdominal discomfort continued to be independently related with an ovarian cancer diagnosis when 180 days of symptoms were excluded.

Conclusions: Often months before the disease is discovered, women with ovarian cancer report their symptoms to their primary care physician. This study gives doctors and those who create guidelines a solid evidence framework for choosing which patients to investigate.

Keywords: Postmenopausal bleeding; Urogenital flow; Abdominal distension; Frequent urination; Abdominal discomfort