Low Ovarian Cancer Detection Rate by Symptoms Alone

Transvaginal ultrasound may be a more sensitive way to look for ovarian malignancy

THURSDAY, July 16 (HealthDay News) -- Using symptoms alone only identifies 20 percent of women with malignant tumors, but a negative result on the symptoms index combined with a negative ultrasound result is highly indicative of a benign mass, according to a study published online July 14 in Cancer.

Edward J. Pavlik, Ph.D., of the University of Kentucky Medical Center in Lexington, and colleagues conducted a study of 272 women selected from 31,748 women enrolled in annual transvaginal screening for ovarian cancer, to gather information on symptoms of ovarian cancer correlated with ultrasound and surgical pathology. Symptom information was gathered through a patient questionnaire, including a question regarding the patients' confidence levels about their answers, to identify potential recall bias.

The researchers found that, although ovarian cancer could be identified by symptoms, transvaginal ultrasound was better at detecting malignancies, with sensitivity of 73.3 percent versus 20 percent for symptoms. However, the analysis of symptoms was better than transvaginal ultrasound for the diagnosis of benign tumors (91.3 versus 74.4 percent).

"Despite the authors attempts to compensate for this potential [patient recall] bias, they cannot answer their own study question with the current study design," writes the author of an accompanying editorial. "Prospective collection of symptoms information from women who are followed in a prospective screening program is the more appropriate way to study the potential benefit of both screening tools. The authors' conclusions regarding the minimal incremental gains they observed should not dissuade others from further study of this important research question."

The study was supported by grants from the Telford Foundation and the Department of Health and Human Services in Kentucky.

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