Belly bloat, abdominal discomfort, the feeling of a too-full tummy. It’s easy to dismiss such vague complaints as simple digestive upset or some other minor malady. So it’s no wonder that many women don’t bother to mention such symptoms…and doctors often don’t think to inquire about them.
Problem: These subtle symptoms also can be warning signs of ovarian cancer—and ignoring them can be a potentially deadly mistake.
When ovarian cancer is caught and treated early, while still confined to the ovary, the cure rate is about 90%…but when diagnosis is delayed until after the cancer has spread, the five-year survival rate plunges to just 20% to 30%. So even though ovarian cancer is relatively uncommon, affecting fewer than 2% of women, its deadly nature makes it a formidable foe.
Can’t screening tests be given to all women to help detect the disease early on? Not a good idea. Currently available tests—the CA-125 blood test (which measures markers for ovarian cancer) and ultrasound scan of the ovaries—unfortunately have high rates of false-positive results. Since an operation is needed to confirm the diagnosis, these screening tests can lead to unnecessary surgeries in which healthy ovaries are removed and women are placed at risk for surgical complications such as infections and blood clots. That’s why the US Preventive Services Task Force recently reaffirmed its recommendation against routine ovarian cancer screening.
Encouraging news: In response, researchers have been working to develop a simpler, safer screening tool that could be used for all women, with the goal of identifying those who truly are most likely to benefit from further testing. And now a new study, though small, suggests a simple step in the right direction.
The key is a single-question patient questionnaire that typically takes less than two minutes to complete and can be done right in the doctor’s office. It gets patients and doctors thinking about the warning signs that merit further investigation.
Study participants included 1,200 women ages 40 to 87 who happened to have appointments at a Seattle clinic (for instance, for routine mammograms or follow-ups to previous appointments). While they were there, the women wrote their answers to the question, “Are you currently experiencing any of the following symptoms frequently?” The symptoms listed…
- Pain: Abdominal/pelvic pain
- Eating: Feeling full quickly or unable to eat normally
- Abdomen: Abdominal bloating or increased abdomen size
Women who answered yes to the question further indicated how many days per month they were experiencing the symptom and how long they had had the symptom. Participants were considered to be “positive for symptoms” if any of the above signs were currently occurring more than 12 times per month and were present for less than one year. (Past symptoms that disappeared do not suggest ovarian cancer.)
Results: 5.5% of the women were positive for symptoms, and most of these patients chose to go on with further testing. During the one-year follow-up period, one woman was diagnosed with ovarian cancer—and she was among those who had answered yes to the questionnaire. Importantly, among the women who reported no symptoms, none ended up being diagnosed with the disease during the follow-up—a testament to the accuracy of the questionnaire as a screening tool.
Researchers hope that primary-care doctors will soon begin using this simple questionnaire to identify patients who may have ovarian cancer.
In the meantime: If you develop any of the above symptoms and they are new to you and occur frequently, you can help protect yourself by immediately alerting your doctor. In most cases, they will not signal ovarian cancer—but women who do have such symptoms are at higher risk than other women and may benefit from follow-up with the currently available tests.
Source: M. Robyn Andersen, PhD, MPH, is a cancer researcher at the Fred Hutchinson Cancer Research Center and an affiliate associate professor of health services and epidemiology at the University of Washington School of Public Health, both in Seattle. She is the lead author of a study on an ovarian cancer screening questionnaire published in Open Journal of Obstetrics and Gynecology.