GPs could offer simple test for early detection of ovarian cancer

By Dr. Ananya Mandal, MDApr 28 2011

Health experts have said that hundreds of lives could be saved a year if GPs were quicker to spot symptoms of the disease - dubbed a “silent killer” because it is hard to diagnose early enough. Ovarian cancer kills almost 4,400 women in Britain every year. It kills one every two hours that makes it the fourth most common cancer in females. While almost three times as many die from breast cancer, those diagnosed with ovarian cancer are far more likely to die earlier.

These findings that come in The Lancet show that about 82 per cent of British women with breast cancer survive to at least five years after diagnosis. For ovarian cancer the figure is just 36 per cent. The key reason for the difference is late diagnosis. As a result (WED) the National Institute for Health and Clinical Excellence (Nice) is publishing its first guidelines to help doctors identify and manage the disease.

These new diagnostic guidelines include checking the level of a blood protein called CA125, if a women tells her GP she has been persistently experiencing symptoms which could be ovarian cancer. The test, which costs around £20, is already available on the NHS but offering it sooner could give women a greater chance of survival by speeding up diagnosis and treatment.

Dr Fergus Macbeth, director of Nice's Centre for Clinical Practice, said older women were often misdiagnosed with irritable bowel syndrome (IBS) when they actually had early stage ovarian cancer. Other possible symptoms include feeling full quickly and the need to urinate urgently or quickly. He said, “While the symptoms are nonspecific, their persistence can be an important indicator of the disease.” Women who experienced them 12 or more times a month should see a doctor, the guidelines say.

Charles Redman, a consultant gynecologist oncologist who sat on the guidelines panel, said the average length of time from a woman starting to experience symptoms to being diagnosed was 18 months. “Far too many women are being referred to hospitals for suspected ovarian cancer once their disease is already at an advanced stage,” he said, adding that the current situation was “poor” compared with elsewhere in Europe and “extremely wasteful”

However the guidelines also warn that although the CA125 test is a useful indicator, it only picked up around 50 per cent of early stage ovarian cancers. Sometimes women with tumors had no raised level of the protein, while others with raised levels sometimes did not have ovarian cancer.

Frances Reid, of the charity Target Ovarian Cancer, said, “This guidance tackles for the first time critical issues facing women who develop ovarian cancer, and could save hundreds of lives.” British women must no longer die from delayed diagnosis, she said.

Dr Clare Gerada, of the Royal College of GPs, said, “This is not about increasing GPs' workloads - it is about working as effectively as possible with the tools available to us, to achieve the best possible outcomes for women.” Ovarian Cancer Action's chief executive, Gilda Witte, said, “Significant progress has been made in improving survival figures for ovarian cancer over the last 10 years, but there is a long way to go in beating the disease.”