Certain symptom patterns may provide clues for presence of ovarian masses.

2004 JUL 1 - (NewsRx.com & NewsRx.net) -- Symptoms experienced by women that are more severe or frequent than expected and of recent occurrence warrant further diagnostic investigation because they are more likely to be associated with both benign (non-cancerous) and malignant (cancerous) ovarian masses, scientists recommend.

"Ovarian cancer has often been called the 'silent killer' because symptoms are not thought to develop until advanced stages when chance of cure is poor," wrote Barbara A. Goff, MD, from the University of Washington School of Medicine, Seattle, and colleagues in the June 9, 2004, issue of the Journal of the American Medical Association (JAMA).

The authors looked at previous research which found that "80% to 90% of women with early stage disease will report symptoms for several months prior to diagnosis ... Identification of early symptoms may have important clinical implications because 5-year survival for early stage disease is 70% to 90% compared with 20% to 30% for advanced-stage disease."

Goff and colleagues compared the frequency, severity, and duration of symptoms between women with ovarian masses (n=128) and women in the control group who visited two primary care clinics (n=1,709). The women were asked to complete an anonymous survey of symptoms experienced over the past year (July 2001 - January 2002). Severity of symptoms was rated on a 5-point scale, duration was recorded, and frequency was indicated as number of episodes per month.

"In the clinic population, 72% of women had recurring symptoms with a median (mid-point) number of two symptoms. The most common were back pain (45%), fatigue (34%), bloating (27%), constipation (24%), abdominal pain (22%), and urinary symptoms [urgency/frequency] (16%)," the researchers reported.

"Comparing ovarian cancer cases to clinic controls resulted in an [increased] odds ratio of 7.4 for increased abdominal size; 3.6 for bloating; 2.5 for urinary urgency; and 2.2 for pelvic pain. Women with malignant masses typically experienced symptoms 20 to 30 times per month and had significantly more symptoms of higher severity and more recent onset than women with benign masses or controls. The combination of bloating, increased abdominal size, and urinary symptoms was found in 43% of those with cancer, but in only 8% of those presenting to primary care clinics," Goff and coauthors wrote.

"While our current study did find that women who present to primary care clinics frequently have vague symptoms that can be associated with ovarian cancer, the important ...