Ovarian cancer guidelines 'ignore key symptom'

Ovarian cancer cases are being missed because diagnosis guidelines do not mention abdominal distension, the symptom most likely to be associated with the cancer, a study suggests.

Researchers from the University of Bristol examined the symptoms that could indicate ovarian cancer in women presenting to primary care. They then calculated the chance that a woman with a particular symptom actually had the cancer.

They found that six symptoms associated with ovarian cancer had a positive predictive value below 1%. These were: urinary frequency, abdominal pain, postmenopausal bleeding, loss of appetite, rectal bleeding, and abdominal bloating.

However, abdominal distension, which is not included in NICE referral guidelines for suspected cancer, had a positive predictive value of 2.5%.

The authors conclude that abdominal distension is ‘a common important symptom and warrants rapid investigation'.

Their research is published  in the BMJ.



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