UICC World Cancer Congress 2006

Objective: Develop an effective assessment tool specific for the symtoms suggestive of ovarian cancer. This tool needs to distinguish which women with symptoms suggestive of ovarian cancer need medical evaluation and diagnostic testing from those women who do not require such interventions.

Methods: The study population included 1699 women: group A included women presenting for surgery for a pelvic mass (n=206); group B were women 40 and older from public settings (n=1185); group C were women seeking medical care for other diagnosis (n=247); Women with ovarian cancer (n=113) are subgroup of A.

Results: 1. Symptoms of ovarian cancer (ovarian cancer vs group C): can feel abdominal mass(OR 9.85 [4.53,21.40]) ; increased abdominal size (OR 9.61[5.56,16.61]); pelvic bloating (OR 9.43;[5.29;11.81]); abdominal bloating (OR 5.88[3.49, 9.91]); fullness (OR 3.41[2.10;5.55]; abdominal pain (OR 2.67[1.61,4.43]); pelvic pain (OR 2.55[1.52,4.28]); constipation (OR 2.22[1.38,3.59]); fatigue (OR 2.12[1.31,3.43]). Results were similar comparing ovarian cancer patients to women seeking medical care (group C) as were seen comparing ovarian cancer patients to general population of women 40 years of age and older (group B).

2. Symptoms of cancer vs benign mass: abdominal bloating (OR 2.39[1.27,4.47]) increased abdominal size ( OR 2.13[1.11,4.09]); pelvic bloating (OR 1.92[1.02,3.60]).

3. Prevalence of symptoms suggestive of ovarian cancer in women with ovarian cancer: feel a mass (33%); increased abdominal size (73%); abdominal bloating (75%); pelvic bloating (61%); abdominal pain (68%); fullness (55%); pelvic pain (49%); constipation (55%); fatigue (68%).

4. Prevalence of symptoms suggestive of ovarian cancer in a cross section of women age 40 and older: feel a mass (3.5%); increased abdominal size (22%); abdominal bloating (34%); pelvic bloating (23%); abdominal pain (32%); fullness (30%); pelvic pain (25% ); constipation (37%); fatigue (51%).

5. Women with ovarian cancer reported their symptoms to their doctor within one month 30% of the time, within two months 49% of the time and within 4 months 66% of the time.

Conclusions: Symptoms most suggestive of ovarian cancer are common in the general population. The constellation of symptoms in the same individual may warrant evaluation. This study did not prospectively test evaluation techniques such as CA 125, pelvic exam, and transvaginal ultrasonography.