Ovarian Cancer: Early Symptom Patterns

Koldjeski, Dixie; Kirkpatrick, Mary K.; Swanson, Melvin; Everett, Lou; Brown, Sylvia T.

doi:10.1188/03.onf.927-933

Cited by 25 publications

(12 citation statements)

References 34 publications

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“…We compared early symptoms of ovarian cancer in two young groups of patients and matched control group. The symptoms that showed up in this young case-control comparison are very similar to those that have been reported previously from different settings in all age groups (Pearse & Behrman 1954;Ranney & Ahmad 1979;Smith & Anderson 1985;Flam et al 1988;Wikborn et al 1993;Goff et al 2000Goff et al , 2004Olson et al 2001;Koldjeski et al 2003;Webb et al 2004). Our finding that a high proportion of women with ovarian cancer noted some symptoms in the months before diagnosis is consistent with reports of case series (Pearse & Behrman 1954;Flam et al 1988;Luesley 1991;Goff et al 2000), which found that nearly all patients had symptoms (Flam et al 1988) estimated that only 2% of patients of all ages with ovarian cancer are asymptomatic.…”

Section: Discussionsupporting

confidence: 89%

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Symptoms of ovarian cancer in young patients 2 years before diagnosis, a case-control study

Behtash

Azar

Fakhrejahani

2008

European Journal of Cancer Care

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Ovarian cancer is usually diagnosed after it has spread and is difficult to cure. Most of attempts to identify early symptoms have lacked control group or have been based on interviews. We examined early symptoms of ovarian cancer in young women and compared with a matched control group. Symptoms recorded in medical files of 100 women aged 15-35 years with ovarian cancer who were referred to Vali-Asr hospital between 1995 and 2005. Symptoms of cases were compared with 100 matched controls during 2 years before diagnosis. More cases (95%) than controls (28%) complained of at least one symptom up to 2 years before diagnosis, most of these symptoms were abdominal. Others included urinary symptoms, infertility and abnormal vaginal bleeding. The most common symptoms among cases were: unusual abdominal or lower back pain 52%, unusual bloating, fullness and pressure in the abdomen 37%, gastro-intestinal problems 36%. In total, 11%, 3% and 12% of controls reported these symptoms respectively, resulting in odds ratios of 8.7, 18.9 and 4.1 respectively for these symptoms. Unusual abdominal or lower back pain, fullness and pressure, gastrointestinal, urinary problems and infertility should make women and physicians more aware of changes associated with ovarian cancer.

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Section: Discussionsupporting

confidence: 89%

“…Other studies have been based on interviews or selfadministered questionnaires completed by patients or their families (Smith & Anderson 1985;Goff et al 2000Goff et al , 2004Olson et al 2001;Koldjeski et al 2003;Webb et al 2004). Only two of these included control groups (Olson et al 2001;Goff et al 2004).…”

Section: Introductionmentioning

confidence: 99%

Symptoms of ovarian cancer in young patients 2 years before diagnosis, a case-control study

Behtash

Azar

Fakhrejahani

2008

European Journal of Cancer Care

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“…Additionally, in several cases, symptom data have been recorded using checklists, which have been limited in the range of symptoms. 6,[10][11][12][13][14][15][16][17] This paper reports the results of a study that used both qualitative and quantitative methods to investigate symptoms associated with ovarian cancer.…”

Section: Introductionmentioning

confidence: 99%

Identifying symptoms of ovarian cancer: a qualitative and quantitative study

Bankhead

Collins

Stokes-Lampard

et al. 2008

BJOG

108

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Introduction Symptoms of ovarian cancer are often vague and consequently a high proportion of women with ovarian cancer are not referred to the appropriate clinic.Objective To identify diagnostic factors for ovarian cancer.Design A qualitative and quantitative study.Setting Four UK hospitals.Sample One hundred and twenty-four women referred to hospital with suspected ovarian malignancy.Methods Women were interviewed prior to diagnosis (n = 63), or soon after. A thematic analysis was conducted. Emergent symptoms were quantitatively analysed to identify distinguishing features of ovarian cancer.Main outcomes Symptoms in women with and without ovarian cancer.Results Diagnoses comprised 44 malignancies, 59 benign gynaecological pathologies and 21 normal findings. Of the malignancies, 25 women had stage III or more disease, with an average age of 59 years. The benign/normal cohort was significantly younger (48 years). Multivariate analysis revealed persistent abdominal distension (OR 5.2, 95% CI 1.3-20.5), postmenopausal bleeding (OR 9.2, 95% CI 1.1-76.1), appetite loss (OR 3.2, 95% CI 1.1-9.2), early satiety (OR 5.0, 95% CI 1.6-15.7) and progressive symptoms (OR 3.6, 95% CI 1.3-9.8) as independent, statistically significant variables associated with ovarian cancer. Fluctuating distension was not associated with ovarian cancer (OR 0.4, 95% CI 0-4.1). Women frequently used the term bloating, but this represented two distinct events: persistent abdominal distension and fluctuating distension/discomfort.Conclusions Ovarian cancer is not a silent killer. Clinicians should distinguish between persistent and fluctuating distension. Recognition of the significance of symptoms described by women could lead to earlier and more appropriate referral.

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“…As previously reported by Goff et al [6], these symptoms include pelvic pain, abdominal pain, feeling full quickly, inability to eat normally, abdominal bloating, increased abdominal size, and urinary symptoms. Additional studies of ovarian cancer symptoms have supported these results and the presence of similar symptoms [7–12]. …”

Section: Introductionmentioning

confidence: 66%

The temporal stability of the Symptom Index among women at high-risk for ovarian cancer

Lowe

Andersen

Urban

et al. 2009

Gynecologic Oncology

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Objective-To evaluate the temporal stability of self-reported symptoms known to be associated with ovarian cancer.Methods-This report is a longitudinal analysis of symptom reporting from 123 women who participated in the Seattle-based Ovarian Cancer Early Detection Study (OCEDS). The OCEDS population includes women at increased risk of ovarian cancer based on a family history of cancer or a BRCA I/II mutation. Data on symptoms were collected at two time points using a Symptoms Index that included abdominal pain, pelvic pain, feeling full quickly, inability to eat normally, abdominal bloating, and increased abdominal size.Results-There was a median of 101 days between the two time points, with a range of 72-332 days. The median age of the women was 51, with a range of 32-79 years. Abdominal bloating was the most commonly reported symptom at both time points. The symptom least commonly reported at the two time points was inability to eat normally. The Symptoms Index was negative at both time points for 86% of all women and positive at both time points for 2% of all women. There were no statistically significant patterns of change for symptom reporting between time points.Conclusions-The Symptoms Index and women's report of abdominal pain, pelvic pain, feeling full quickly, unable to eat normally, abdominal bloating, increased abdominal size were stable between two time points in this sample. These findings provide evidence that longitudinal measurements of symptoms reporting by women in a screening study are likely to be reliable.

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Ovarian Cancer: Early Symptom Patterns

Abstract: Pelvic assessments should be reformulated to conceptualize early symptoms, risk factors, and family cancer history as a dynamic, interconnected whole to guide and interpret ovarian health.

Cited by 25 publications

References 34 publications

Symptoms of ovarian cancer in young patients 2 years before diagnosis, a case-control study

Symptoms of ovarian cancer in young patients 2 years before diagnosis, a case-control study

Identifying symptoms of ovarian cancer: a qualitative and quantitative study

The temporal stability of the Symptom Index among women at high-risk for ovarian cancer

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