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Women with ovarian cancer would be diagnosed sooner and have a better prognosis if both they and their physicians were more familiar with its symptoms and if appropriate tests were done earlier.

A study, published in Cancer (2000;89:2068-2075) found that most women diagnosed with ovarian cancer did, in fact, have symptoms prior to diagnosis but were unaware the symptoms could be signs of cancer. Physicians often initially attributed the symptoms to irritable bowel syndrome, stress, gastritis, depression, or constipation, or were unable to discover a cause for the symptoms.

Almost 90% of the women in the study who were diagnosed with ovarian cancer at an early stage reported having one or more symptoms, such as abdominal pain, bloating, pelvic pain, or back pain.

Barbara A. Goff, MD, assistant professor of obstetrics and gynecology at the University of Washington in Seattle, and her team examined the results of surveys completed by 1,725 women with ovarian cancer in 46 states and four Canadian provinces.

Almost 90% of the women in the study who were diagnosed with ovarian cancer at an early stage reported having one or more symptoms, such as abdominal pain, bloating, pelvic pain, or back pain. Only 3% of women diagnosed with advanced ovarian cancer did not report any symptoms.

For just 55% of all the women surveyed, the correct diagnosis was made within two months after symptoms appeared. It took three to six months for a diagnosis in 19% of the women, and more than a year for 11%. The more delayed the diagnosis, the more advanced the cancer was when it was identified.

The authors conclude that providers should perform pelvic exams on women with abdominal, pelvic, and constitutional symptoms. In addition, the ACS recommends that a pelvic exam should be part of an annual cancer-related check-up for women 40 years of age and older. Women 20 to 39 years of age should have a cancer-related check-up every three years.