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A study of primary care physicians
Article first published online: 16 MAR 2011
Copyright © 2011 American Cancer Society
Volume 117, Issue 19, pages 4414–4423, 1 October 2011
How to Cite
Goff, B. A., Matthews, B., Andrilla, C. H. A., Miller, J. W., Trivers, K. F., Berry, D., Lishner, D. M. and Baldwin, L.-M. (2011), How are symptoms of ovarian cancer managed?. Cancer, 117: 4414–4423. doi: 10.1002/cncr.26035
We thank Blythe Ryerson from the Centers for Disease Control and Prevention for her early contributions to the development of the study's methods and Gilmore Research in Seattle, Washington for conducting the survey.
See editorial on pages 4340-2, this issue.
- Issue published online: 16 SEP 2011
- Article first published online: 16 MAR 2011
- Manuscript Accepted: 6 DEC 2010
- Manuscript Revised: 2 DEC 2010
- Manuscript Received: 30 SEP 2010
- Disease Control and Prevention (CDC). Grant Number: U48DP001911
- CDC. Grant Number: U48DP001911
- National Cancer Institute
- primary care physicians;
- ovarian cancer;
- transvaginal ultrasound
A study was undertaken to identify the diagnostic approaches that primary care physicians and gynecologists undertake in women with symptoms associated with ovarian cancer.
A vignette-based survey was mailed to 3200 primary care physicians from the American Medical Association Physician Masterfile. The vignette described a 55-year-old woman with symptoms associated with ovarian cancer, although ovarian cancer was never mentioned. The authors evaluated patient, physician, and practice characteristics associated with a workup that could detect ovarian cancer.
The survey response rate was 61.7%. After exclusions, 1532 physicians were included. Overall, 89.5% of physicians reported that they would recommend testing that can detect ovarian cancer (71.2% ultrasound; 25.4% pelvic computed tomography; 26.5% CA125). In adjusted analysis, the only patient factor associated with ovarian cancer testing was symptom type, genitourinary versus gastrointestinal (risk ratio, 1.07; 95% confidence interval, 1.03-1.11). Physician and practice characteristics associated with recommending of ovarian cancer testing included specialty (gynecologists > family physicians and internists); type of practice (group > solo); clinical teaching (yes > no); and within Census division, location of practice, with all Central (East, West, North, and South) and Atlantic (Middle and South) areas having a lower likelihood than New England.
On the basis of a vignette in which a woman reported symptoms associated with ovarian cancer, the majority of primary care physicians and gynecologists would not recommend CA125, but would recommend imaging of the pelvis. Gynecologists, physicians involved with clinical teaching, and those in group practices were significantly more likely to recommend testing that could lead to an ovarian cancer diagnosis. Cancer 2011;. © 2011 American Cancer Society.