Fax: (206) 543-3915.
Development of an ovarian cancer symptom index†
Possibilities for earlier detection
Article first published online: 11 DEC 2006
Copyright © 2006 American Cancer Society
Volume 109, Issue 2, pages 221–227, 15 January 2007
How to Cite
Goff, B. A., Mandel, L. S., Drescher, C. W., Urban, N., Gough, S., Schurman, K. M., Patras, J., Mahony, B. S. and Andersen, M. R. (2007), Development of an ovarian cancer symptom index. Cancer, 109: 221–227. doi: 10.1002/cncr.22371
The contents of this article are solely the responsibility of the authors and do not necessarily represent the views of the Marsha Rivkin Center for Ovarian Cancer Research or the National Cancer Institute.
- Issue published online: 8 JAN 2007
- Article first published online: 11 DEC 2006
- Manuscript Accepted: 9 OCT 2006
- Manuscript Revised: 4 OCT 2006
- Manuscript Received: 11 SEP 2006
- Marsha Rivkin Center for Ovarian Cancer Research (Seattle, WA)
- National Institutes of Health/National Cancer Institute. Grant Number: P50 CA83636 to N
- Urban (“Pacific Ovarian Cancer Research Consortium: Specialized Program of Research Excellence in Ovarian Cancer.”)
- ovarian cancer;
- early diagnosis;
- case-control study
Currently, screening for ovarian cancer is not recommended for the general population. Targeting women with specific symptoms for screening has been evaluated only recently, because it was believed that symptoms had limited specificity.
A case-control study of 149 women with ovarian cancer, including 255 women who were in a screening program and 233 women who were referred for pelvic/abdominal ultrasound, was conducted by inviting women to complete a survey of symptoms. Patients were divided randomly into an exploratory group and a confirmatory group. Symptom types, frequency, severity, and duration were compared between cases and controls. Logistic regression analyses were used to determine which factors independently predicted cancer in the exploratory group and then were used to develop a symptom index, which was tested for sensitivity and specificity in the confirmatory group.
Symptoms that were associated significantly with ovarian cancer were pelvic/abdominal pain, urinary urgency/frequency, increased abdominal size/bloating, and difficulty eating/feeling full when they were present for <1 year and occurred >12 days per month. In a logistic regression analysis, symptoms that were associated independently with cancer were pelvic/abdominal pain (P < .001), increased abdominal size/bloating (P<.001), and difficulty eating/feeling full (P = .010). A symptom index was considered positive if any of those 6 symptoms occurred >12 times per month but were present for <1 year. In the confirmatory sample, the index had a sensitivity of 56.7 for early-stage disease and 79.5% for advanced-stage disease. Specificity was 90% for women age >50 years and 86.7% for women age <50 years.
Specific symptoms in conjunction with their frequency and duration were useful in identifying women with ovarian cancer. A symptom index may be useful for identifying women who are at risk. Cancer 2007. © 2006 American Cancer Society.