Symptoms have little value for early detection of ovarian cancer

January 28, 2010, Journal of the National Cancer Institute

Use of symptoms to trigger a medical evaluation for ovarian cancer does not appear to detect early-stage ovarian cancer earlier and would likely result in diagnosis in only 1 out of 100 women in the general population with such symptoms, according to an article published online January 28 in the Journal of the National Cancer Institute.

Researchers at Fred Hutchinson Cancer Research Center in Seattle assessed the predictive value of certain symptoms, including abdominal pain or bloating and urinary frequency, which were cited in a recent consensus statement as a way to diagnose ovarian cancer earlier.

Mary Anne Rossing, Ph.D., of the Program in Epidemiology at Fred Hutchinson, and colleagues conducted in-person interviews with 812 patients aged 35-74 years who had epithelial ovarian cancer that was diagnosed from 2002 through 2005. They compared the results from these case patients with results from interviews with 1,313 population-based control subjects—women who did not have ovarian cancer. The researchers assessed the sensitivity, specificity, and positive predictive value of a proposed symptom index and of symptoms included in the consensus recommendation.

Symptoms appeared in most case patients only about 5 or fewer months before diagnosis. Women with early-stage ovarian cancer were somewhat less likely to have symptoms (except nausea) than those with late-stage cancer. The estimated positive predictive value of the symptoms was 0.6%-1.1% overall and less than 0.5% for early-stage disease.

The authors conclude that 100 symptomatic women would need to be evaluated to detect one woman with ovarian cancer.

"The low of symptoms to detect ovarian cancer—particularly at an early stage—argues for a cautious approach to the use of symptom patterns to trigger extensive medical evaluation for ovarian cancer," the authors write.

In an accompanying editorial, Beth Y. Karlan, M.D., and Ilana Cass, M.D., of the Division of Gynecologic Oncology at Cedars-Sinai Medical Center in Los Angeles, note the strengths of the study, including in-person interviews and large number of patients, but also point out its limitations: inherent recall bias and survival bias in case patients and control subjects. Recall bias is always a possibility in case-control studies in that case subjects may be more likely to remember symptoms than control subjects.

"Importantly, these findings remind us that wide recognition of symptoms alone will not incrementally improve the overall survival from ovarian cancer," the editorialists write. "Rather, they highlight the urgent need to develop better molecular markers and improved imaging modalities for screening."

Related Stories

Recommended for you

Researchers create a drug to extend the lives of men with prostate cancer

March 16, 2018
Fifteen years ago, Michael Jung was already an eminent scientist when his wife asked him a question that would change his career, and extend the lives of many men with a particularly lethal form of prostate cancer.

Machine-learning algorithm used to identify specific types of brain tumors

March 15, 2018
An international team of researchers has used methylation fingerprinting data as input to a machine-learning algorithm to identify different types of brain tumors. In their paper published in the journal Nature, the team ...

Higher doses of radiation don't improve survival in prostate cancer

March 15, 2018
A new study shows that higher doses of radiation do not improve survival for many patients with prostate cancer, compared with the standard radiation treatment. The analysis, which included 104 radiation therapy oncology ...

Joint supplement speeds melanoma cell growth

March 15, 2018
Chondroitin sulfate, a dietary supplement taken to strengthen joints, can speed the growth of a type of melanoma, according to experiments conducted in cell culture and mouse models.

Improved capture of cancer cells in blood could help track disease

March 15, 2018
Tumor cells circulating throughout the body in blood vessels have long been feared as harbingers of metastasizing cancer - even though most free-floating cancer cells will not go on to establish a new tumor.

Area surrounding a tumor impacts how breast cancer cells grow

March 14, 2018
Cancer is typically thought of as a tumor that needs to be removed or an area that needs to be treated with radiation or chemotherapy. As a physicist and cancer researcher, Joe Gray, Ph.D., thinks differently.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.