ovarian cancer : Symptoms of ovarian cancer

Of the 128 women with a pelvic mass, 84 had benign masses and 44 had malignancies, 11 with early stage disease and 33 with advanced disease. Women with malignancies had a higher median number of symptoms and recurring symptoms than the clinic patients, with 36 percent having had symptoms for two months or less, 24 percent having symptoms for two to three months, and 14 percent having symptoms longer than one year. When comparing women who had malignancy with women who had IBS (and, therefore, had high numbers of symptoms), a significantly higher percentage of women with malignancy had pelvic pain (41 versus 25 percent), bloating (70 versus 49 percent), increased abdominal size (64 versus 32 percent), and urinary tract symptoms (55 versus 33 percent). Women with ovarian cancer were significantly more likely than the clinic group to have pelvic pain, abdominal pain, difficulty eating, bloating, increased abdominal size, and urinary urgency.

In comparing groups of symptoms, 43 percent of women with ovarian cancer had the combination of bloating, abdominal pain, and urinary tract symptoms, whereas 10 percent of women with benign masses, 13 percent of women with IBS, and 8 percent of clinic women had this combination. Symptoms were more severe and more frequent in women with ovarian cancer or IBS than in clinic patients. Symptoms typically were continuous in women with malignancies, compared with occasional and intermittent symptoms in clinic patients. Women with benign masses also often had daily symptoms, which overlapped with the symptoms experienced by women with ovarian cancer, but included constipation. Finally, women with ovarian cancer had a much shorter duration of symptoms at a median of six months or less compared with 12 to 24 months in clinic patients and those with IBS.

No effective screening test exists for ovarian cancer. The symptoms most commonly reported in patients with ovarian cancer include bloating, increased abdominal size, abdominal or pelvic pain, and urinary tract symptoms, although these also are common in women with benign masses. Symptoms tend to be more severe, more frequent, and of shorter duration in women with malignant masses than in women with benign masses. Women with ovarian cancer also are more likely to present with a combination of symptoms.The authors conclude that this study provides more evidence that ovarian cancer is not an asymptomatic disease. Symptoms that are more severe, more frequent, and of recent onset are more likely to be associated with ovarian masses.

Goff BA, et al. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA June 9, 2004;291:2705-12.