Picture Forum: Ovarian cancer Guidelines ignore 'key symptom'

Ovarian cancer diagnosis guidelines do not mention abdominal distension

Carcinoma cells in the human ovary. The condition is known as endometrioid carcinoma because these cells resemble carcinoma of the uterus. Two types of cells are seen in this coloured scanning electron micrograph: some ciliated cells with tufts of cilia (yellow) and abundant secretory cells with microvilli (purple)

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

Hamilton W, Peters TJ, Bankhead C et al. Risk of ovarian cancer in women with symptoms in primary care: population based case-control study. BMJ 2009; 339: b2998.

Want news like this straight to your inbox?
Sign up for our bulletins

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Already registered?
Sign in

MIMS Product Slides

Product overviews prepared by the MIMS team, in a handy slide format.

Click here

Slides are initiated, funded & reviewed by the companies specified.

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

MIMS Adviser

Especially created for prescribing influencers.

Request free copy

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases