Sept. 25, 2012 -- Screening all women for ovarian cancer does more harm than good. But a three-item questionnaire identifies women most likely to benefit from further tests.
The U.S. Preventive Services Task Force recently recommended against routine testing for ovarian cancer. The reason is that two tests -- the CA-125 blood test and ultrasound imaging -- tell too many women they might have cancer when they don't.
The result: far too many unnecessary surgeries.
Now researchers at the Fred Hutchinson Cancer Research Center and the University of Washington may have a better way to identify women whose ovarian cancer risk justifies more tests: a 90-second questionnaire asking about current ovarian cancer symptoms.
Ovarian cancer is deadly unless caught early. Women treated at the first sign of symptoms are most likely to be cured. But the symptoms are not specific and are easily missed.
Ovarian Cancer Symptoms
M. Robyn Andersen, PhD, a member of the Hutchinson Center, led a team that tried a simple idea in a 1,200-woman study. During a visit to their doctor's office, women were met in the waiting room by a nurse. The nurse gave them a simple questionnaire.
The questionnaire asked whether the women were having frequent symptoms of:
- Abdominal and/or pelvic pain
- Feeling full quickly and/or being unable to eat normally
- Abdominal bloating and/or increased abdominal size
Overall, only about 1 in 20 women reported one or more of these symptoms. Since 57% of women with early-stage ovarian cancer and 80% of women with advanced ovarian cancer have such symptoms, these women may be considered at higher risk.
Most women with these symptoms do not have ovarian cancer. But they would benefit from further evaluation by a medical professional to rule out conditions such as fibroids or irritable bowel syndrome.
"We are still waiting for a true screening test for ovarian cancer," Andersen says. "But getting tested when having symptoms does seem to be a way to improve outcomes."
Andersen notes that women who've had these symptoms for more than a year likely do not have ovarian cancer. But a woman whose symptoms have been frequent for a couple of weeks or months may benefit from a visit to the doctor.
Andersen has asked the National Institutes of Health to fund a study to test the questionnaire in a larger group of women.
The Andersen study appears in the September 2012 online issue of the Open Journal of Obstetrics and Gynecology.