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Screening Test Detects Ovarian Cancer

Finding shows that quantifying symptoms can be useful in making an earlier diagnosis

A new screening test could help doctors and patients detect ovarian cancer in its early stages before it becomes so advanced that effective treatment is nearly impossible.

Researchers report that the test -- a checklist of symptoms and their frequency -- picked up early stage ovarian cancer 57 percent of the time.

"This provides information both for women and for physicians in terms of what we need to take seriously," said study lead author Dr. Barbara A. Goff, director of gynecologic oncology at the University of Washington.

Ovarian cancer is particularly dangerous: The cure rate is only in the 10 percent to 30 percent range among women with the most advanced forms of the disease, according to Goff. By contrast, as many as 90 percent of ovarian cancers can be cured if detected in the early stages, she said.

 Ovarian cancer is the eighth most common cancer among American women, not including skin cancer, and the fifth leading cause of cancer death. The American Cancer Society estimates there will be about 20,180 new cases of the disease in the United States in 2006, and about 15,310 women will die this year because of it. Around two-thirds of women with ovarian cancer are 55 or older, according to the ACS.

In many cases, a diagnosis comes after the cancer has already spread unnoticed to other parts of the body. "People come in very, very sick," Goff said.

Sometimes, patients don't realize their early symptoms are serious. In some cases, doctors miss the symptoms, which can be vague, or assume they're caused by stress, depression, urinary-tract infections or other causes, she said.

 

Until now, there has been no screening test for ovarian cancer, which has become known as a "silent killer." Still, an estimated 95 percent of women with the disease report having symptoms before diagnosis.

In the new study, Goff and her colleagues asked three groups of women about their symptoms -- 149 women with ovarian cancer, 255 women in a screening program, and 233 women who were told to get pelvic ultrasounds.

The researchers then tried to detect patterns among the survey results. They found that certain symptoms indicated cancer if any one of them was present more than 12 days a month but for less than a year.

The symptoms were: pelvic pain and abdominal pain; urinary frequency and urgency; increased abdominal size or bloating; and difficulty eating or feeling full.

The screening test picked up early stage ovarian cancer 56.7 percent of the time, and advanced-stage disease 80 percent of the time. Also, the test produced false positives -- suggesting women were ill when they weren't -- 10 percent to 13 percent of the time.

The study was expected to be published in the Jan. 15, 2007, issue of the journal Cancer.

The results show "that symptoms can be useful for making a diagnosis of ovarian cancer," Goff said. "We've simply quantified what people should be concerned and not concerned about."

Doctors and patients can use the screening test now. But Goff said that more research needs to be done to determine if the study results hold up in a much larger group.

Sherry Salway Black, executive director of the Ovarian Cancer National Alliance and a survivor of the disease, said the screening test could change how people think about ovarian cancer.

"There is not a lot of general public awareness of the symptoms and risk factors," Black said. "Giving women more information and helping them to be more informed about their own health is critical."

 


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