NICE issued its first guideline on the recognition and initial management of ovarian cancer this week.

The guideline said GPs should refer a woman urgently if physical examination identifies ascites or a pelvic or abdominal mass that is not obviously uterine fibroids.

GPs should also measure serum CA125 levels if a woman reports having on a persistent or frequent basis: persistent abdominal distension, early satiety, loss of appetite, pelvic or abdominal pain, or increased urinary urgency or frequency.

If CA125 levels are over 35IU/ml, an ultrasound scan of the abdomen and pelvis should be arranged. If this scan suggests ovarian cancer, women should be referred urgently for further investigation.

Hull GP Dr Craig Dobson, who helped develop the guideline, pointed out that ovarian cancer is difficult to diagnose from the symptoms alone.

‘It is important for GPs to remember that irritable bowel syndrome rarely presents for the first time in women over fifty,’ he said.

‘Conversely, most ovarian cancers present in women over the age of fifty. Recurrent or prolonged symptoms require a diagnosis at any age.

NICE said that, although chemotherapy and surgery could be effective treatments, women had a greater chance of surviving ovarian cancer if the disease is identified early.