Ovarian cancer – the silent killer?

Background

Ovarian cancer accounts for one in every 25 of all cancers in women, with over 200 000 new diagnoses each year worldwide. Sadly, it has the worst survival rates of all women’s cancers, with only a third of  women surviving for five years or more after diagnosis. As with all cancers, early diagnosis is key. However, currently only one third of ovarian cancers are diagnosed at early stages. This is largely because ovarian cancer has few widely known symptoms – earning it the title of the ‘silent killer’.  

Researchers at the University of Exeter, a DATA-CAN partner, wanted to identify the main symptoms of ovarian cancer that women went to see their GP with, to improve earlier diagnosis and try to save lives.

What did the research find?

The researchers found seven key symptoms that women, who were subsequently diagnosed with ovarian cancer, had been to see their GP about.

These common symptoms were abdominal swelling (also known as distension), abdominal pain, abdominal bloating, increased urinary frequency, postmenopausal bleeding, loss of appetite and rectal bleeding. Of these, the study said that patients with abdominal swelling should undergo urgent investigation.

As well as identifying the important symptoms, the researcher could put numbers on them; in particular, for each symptom, exactly what the chance of ovarian cancer was.

Women with ovarian cancer usually have symptoms and report them to primary care (GPs/Family doctors), sometimes months before diagnosis. This study provides an evidence base for selection of patients for investigation, both for clinicians and for developers of guidelines.

University of Exeter research team

What is the impact on patients?

The research study has helped to improve earlier diagnosis for women with ovarian cancer, therefore saving lives. The team used patient health data to help provide evidence, including a list of seven key symptoms, to GPs and other primary care health professionals to help them to identify the warning signs of ovarian cancer in women at an earlier stage.

What data was used?

The research was undertaken using information from the health records of 212 women, shared by 39 GP practices in Devon, aged over 40 who were diagnosed with ovarian cancer between 2000 and 2007. This data was compared with similar information from 1,060 other patients, of the same age and GP practices, who did not have ovarian cancer. All patient data was anonymised so no names or other personal information was seen by the research team.

Patient and professional views

The research paper won the Royal College of General Practitioners Paper of the Year award in 2009 and was described as making a ‘significant contribution in the case of ovarian cancer’.

The UK’s high rates of late diagnosis have played an important part in keeping five year survival rates low, at just 30% – amongst the lowest in the Western World. In the last 12 months there has been progress with the Department of Health and charities agreeing key messages on symptoms of ovarian cancer for both health professionals and the public, but knowledge of these messages is woefully low.

Anwen Jones, Target Ovarian Cancer

Who funded and collaborated on this work?

This study was funded by the Department of Health’s NIHR School for Primary Care Research funding scheme and ethical permission for the research to be conducted was granted by the North and East Devon research ethics committee.

Further information

British Medical Journal, Risk of ovarian cancer in women with symptoms in primary care: population based case-control study