 |
|
Frequency of Symptoms of Ovarian Cancer in Women Presenting to Primary Care Clinics
Barbara A. Goff, MD;
Lynn S. Mandel, PhD;
Cindy H. Melancon, RN;
Howard G. Muntz, MD
JAMA. 2004;291:2705-2712.
Context Women with ovarian cancer frequently report symptoms prior to diagnosis, but distinguishing these symptoms from those that normally occur in women remains problematic.
Objective To compare the frequency, severity, and duration of symptoms between women with ovarian cancer and women presenting to primary care clinics.
Design, Setting, and Patients A prospective case-control study of women who visited 2 primary care clinics (N = 1709) and completed an anonymous survey of symptoms experienced over the past year (July 2001-January 2002). Severity of symptoms was rated on a 5-point scale, duration was recorded, and frequency was indicated as number of episodes per month. An identical survey was administered preoperatively to 128 women with a pelvic mass (84 benign and 44 malignant).
Main Outcome Measures Comparison of self-reported symptoms between ovarian cancer patients and women seeking care in primary care clinics.
Results In the clinic population, 72% of women had recurring symptoms with a median number of 2 symptoms. The most common were back pain (45%), fatigue (34%), bloating (27%), constipation (24%), abdominal pain (22%), and urinary symptoms (16%). Comparing ovarian cancer cases to clinic controls resulted in an odds ratio of 7.4 (95% confidence interval [CI], 3.8-14.2) for increased abdominal size; 3.6 (95% CI, 1.8-7.0) for bloating; 2.5 (95% CI, 1.3-4.8) for urinary urgency; and 2.2 (95% CI, 1.2-3.9) for pelvic pain. Women with malignant masses typically experienced symptoms 20 to 30 times per month and had significantly more symptoms of higher severity and more recent onset than women with benign masses or controls. The combination of bloating, increased abdominal size, and urinary symptoms was found in 43% of those with cancer but in only 8% of those presenting to primary care clinics.
Conclusions Symptoms that are more severe or frequent than expected and of recent onset warrant further diagnostic investigation because they are more likely to be associated with both benign and malignant ovarian masses.
Author Affiliations: Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle (Drs Goff and Mandel); Conversations, Amarillo, Tex (Ms Melancon); and Virginia Mason Medical Center, Seattle, Wash (Dr Muntz). Dr Melancon is deceased.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLE
Symptoms of Ovarian Cancer—Where to Set the Bar?
Mary B. Daly and Robert F. Ozols
JAMA. 2004;291(22):2755-2756.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Risk of ovarian cancer in women with symptoms in primary care: population based case-control study
Hamilton et al.
BMJ 2009;339:b2998-b2998.
ABSTRACT
| FULL TEXT
Diagnosis of ovarian cancer in primary care
Austoker
BMJ 2009;339:b3286-b3286.
FULL TEXT
A terrible beauty: A physician's story of ovarian cancer
Spano
cfp 2007;53:983-985.
FULL TEXT
Minimizing delays in ovarian cancer diagnosis: an expansion of Andersen's model of 'total patient delay'
Evans et al.
Fam Pract 2007;24:48-55.
ABSTRACT
| FULL TEXT
Characterization of Ovarian Surface Epithelial Cells from the Hen: A Unique Model for Ovarian Cancer
Giles et al.
Exp. Biol. Med. 2006;231:1718-1725.
ABSTRACT
| FULL TEXT
Menopausal hormone therapy and ovarian cancer risk in the National Institutes of Health-AARP Diet and Health Study Cohort.
Lacey et al.
JNCI J Natl Cancer Inst 2006;98:1397-1405.
ABSTRACT
| FULL TEXT
Case 11-2006 -- A 54-Year-Old Woman with a Mass in the Pelvis
Krasner et al.
NEJM 2006;354:1615-1625.
FULL TEXT
Update in Women's Health
Crandall and Pregler
ANN INTERN MED 2005;143:823-829.
FULL TEXT
Early symptoms of ovarian cancer: a case-control study without recall bias
Friedman et al.
Fam Pract 2005;22:548-553.
ABSTRACT
| FULL TEXT
Fruits and Vegetables and Ovarian Cancer Risk in a Pooled Analysis of 12 Cohort Studies
Koushik et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:2160-2167.
ABSTRACT
| FULL TEXT
Is late diagnosis of lung cancer inevitable? Interview study of patients' recollections of symptoms before diagnosis
Corner et al.
Thorax 2005;60:314-319.
ABSTRACT
| FULL TEXT
Ovarian Cancer: The Neglected Diagnosis
Yawn et al.
Mayo Clin Proc. 2004;79:1277-1282.
ABSTRACT
Ovarian Cancer Is Not So Silent
JWatch Women's Health 2004;2004:3-3.
FULL TEXT
Symptoms Associated with Ovarian Cancer
JWatch General 2004;2004:4-4.
FULL TEXT
Symptoms of Ovarian Cancer--Where to Set the Bar?
Daly and Ozols
JAMA 2004;291:2755-2756.
FULL TEXT
|
