Symptoms associated with ovarian cancer, especially abdominal bloating and pain, often start several months prior to diagnosis, a study shows, suggesting that with appropriate testing the diagnosis can be made earlier than it is currently. Ovarian cancer is much more curable when detected early.
In the October 1st issue of Cancer, the study team says their observations "provide objective evidence that patients with ovarian cancer, as a group, are distinguishable symptomatically from controls at least 6 months prior to diagnosis."
Dr. Lloyd H. Smith from the University of California Davis Health System in Sacramento and colleagues documented the pattern of symptoms and associated diagnostic tests prior to the diagnosis among nearly 1,900 women found to have ovarian cancer. The team did the same for roughly 6,000 women with breast cancer, and 11,000 women without cancer.
According to Smith, women with ovarian cancer were much more likely than women with breast cancer and cancer-free women to have "target symptoms," particularly abdominal swelling and pain more than 6 months before they were diagnosed with ovarian cancer.
Also, while abdominal imaging and pelvic imaging with CA125 testing were often used within the 3 months prior to diagnosis of ovarian cancer, relatively few patients had such studies 4 to 36 months prior to diagnosis, the authors report. CA125 is a protein known to be elevated in patients with ovarian cancer.
Smith said it's also worth noting that among women with ovarian cancer, "those who had diagnostic testing usually had abdominal imaging or gastrointestinal procedures, rather than pelvic imaging/CA125 determination."
"Our findings suggest that ovarian cancer could be diagnosed earlier in some patients whose diagnosis is currently delayed by at least 4 months, because physicians order abdominal imaging or perform gastrointestinal procedures before they order a test that is more likely to diagnose ovarian cancer, such as pelvic imaging and/or CA125," the authors write.
Smith advises women with symptoms suggestive of ovarian cancer to "seek a routine medical evaluation." Pelvic imaging and CA125 screening "should be considered" in women with target symptoms of ovarian cancer that persist and are unexplained," Smith said.