Page last updated at 22:59 GMT, Tuesday, 25 August 2009 23:59 UK

Ovarian cancer 'is being missed'

Ovarian cancer scan
Ovarian tumours - as seen here in green - are seen as hard to diagnose

Women with ovarian cancer may not be diagnosed as early as they could be because their symptoms are not being recognised, a study suggests.

Writing in the BMJ, Bristol researchers said the cancer was not a "silent killer" as it is frequently dubbed, but was associated with specific symptoms.

They looked at the case notes of more than 200 women with a cancer diagnosis.

Ovarian cancer is one of the less common cancers but survival rates are relatively low.

Separate research has however shown that cases of the cancer are falling: data from Cancer Research UK indicates numbers are down 20% from a decade ago.

The drop is being attributed in large part to use of the contraceptive pill, which is thought to have a protective effect.

But when it does develop, it is frequently diagnosed in the later stages when the disease has progressed and treatment is harder.

It has been described as silent because it was historically thought to have few symptoms.

However in recent years a number of symptoms have been noted, and it is now recommended that abnormal vaginal bleeding and "palpable masses" be urgently investigated.

Ovarian cancer is not silent, rather its sound is going unheard
Dr William Hamilton

But the team from the University of Bristol said investigation was not mandatory, and that there were in fact seven symptoms associated with this form of cancer.

Most of the symptoms had a relatively low "predictive value" of less than 1%, meaning fewer than one in 100 patients with the complaint actually go on to receive a cancer diagnosis.

But abdominal distension - being permanently bloated - was more frequently associated with a diagnosis and was a symptom present even in the earlier stages of disease.

However , bloating it is not currently on the list of symptoms warranting further investigation.

"If it were, some women could have their diagnosis speeded up by many months," wrote the team, led by Dr William Hamilton.

"Symptoms are common and often reported, even in early - and potentially curable - cancers.

"In that respect our results are encouraging - there is some chance of identifying early ovarian cancer by using symptoms.

"Ovarian cancer is not silent, rather its sound is going unheard."

In some cases in the study - which involved 212 women from across 39 general practices in Devon - women had visited their GPs with symptoms six months prior to diagnosis, but most symptoms were reported in the three months before.

Confused picture

Research released earlier this year found widespread confusion among both doctors and women, both about the symptoms of the disease and when they became apparent.

Around 6,800 women are diagnosed with the cancer each year and only 30% are alive five years after diagnosis.

The charity Target Ovarian Cancer says the survival rate has not improved in 30 years.

"The UK's high rates of late diagnosis have played an important part in keeping five year survival rates low, at just 30% - amongst the lowest in the Western World," said charity chief executive Annwen Jones,

"In the last 12 months there has been progress with the Department of Health and charities agreeing key messages on symptoms of ovarian cancer for both health professionals and the public, but knowledge of these messages is woefully low.

"Change is long over-due and ovarian cancer needs to become a priority."



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