OJOG  Vol.2 No.3 , September 2012
Development of an instrument to identify symptoms potentially indicative of ovarian cancer in a primary care clinic setting
ABSTRACT
Background: Several recently published studies suggest that screening for symptoms could improve the early diagnosis of ovarian cancer. This report describes the development of a simple and reliable method of collecting symptom information in a primary care clinic. Methods: 1200 women, ages 40 - 87, completed several versions of a draft symptom index (SI) assessment form during their visits to a primary care clinic. Factors associated with a positive SI result were examined. Providers were surveyed about acceptability of the symptom screening procedures. Findings: Variation in the instructions provided to women influenced the rate at which women indicated having symptoms indicative of a positive SI, 5% had positive results when written instructions emphasized listing only current symptoms. Women coming to the clinic because of a current medical concern or problem did have higher rates of positive SI results, as did non-white women (p < 0.05). Acceptability by providers was high. Patients could independently complete the SI in under 5 minutes. One patient with a positive SI was diagnosed with ovarian cancer and none with a negative SI developed cancer. Interpretation: A quick paper and pencil form can be used to identify women with symptoms potentially indicative of ovarian cancer. Use of such a form for ovarian cancer screening purposes is acceptable to most women and providers in a primary care clinic setting.

Cite this paper
Robyn Andersen, M. , Goff, B. and Lowe, K. (2012) Development of an instrument to identify symptoms potentially indicative of ovarian cancer in a primary care clinic setting. Open Journal of Obstetrics and Gynecology, 2, 183-191. doi: 10.4236/ojog.2012.23037.
References
[1]   Goff, B.A., et al. (2011) Symptom triggered screening for ovarian cancer: A pilot study of feasibility and acceptability. Gynecologic Oncology, 124, 230-235. doi:10.1016/j.ygyno.2011.10.032

[2]   Gilbert, L., et al. (2012) Assessment of symptomatic women for early diagnosis of ovarian cancer: Results from the prospective DOvE pilot project. The Lancet Oncology, 13, 285-291.

[3]   Goff, B.A., et al. (2004) Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. Journal of American Medical Association, 291, 2705-2712. doi:10.1001/jama.291.22.2705

[4]   Lataifeh, I., et al. (2005) Presenting symptoms of epithelial ovarian cancer. Australian and New Zealand Journal of Obstetrics and Gynaecology, 45, 211-214. doi:10.1111/j.1479-828X.2005.00391.x

[5]   Olson, S.H., et al. (2001) Symptoms of ovarian cancer. Obstetrics & Gynecology, 98, 212-217. doi:10.1016/S0029-7844(01)01457-0

[6]   Ryerson, A.B., et al. (2007) Symptoms, diagnosis, and time to key diagnositc procedures among older US women with ovarian cancer. Obstetrics & Gynecology, 109, 1053-1061. doi:10.1097/01.AOG.0000260392.70365.5e

[7]   Vine, M.F., et al. (2001) Types and duration of symptoms prior to diagnosis of invasive or borderline ovarian tumor. Gynecologic Oncology, 83, 466-471. doi:10.1006/gyno.2001.6411

[8]   Wikborn, C., et al. (1993) Symptoms and diagnostic difficulties in ovarian epithelial cancer. International Journal of Gynaecology & Obstetrics, 42, 261-264. doi:10.1016/0020-7292(93)90222-I

[9]   Gynecologic Cancer Foundation, Society of Gynecological Oncologists, and American Cancer Society (2007) Ovarian cancer symptoms: Consensus statement. http://www.wcn.org/ov-cancer-cons.html.

[10]   NICE (2011) Ovarian cancer: The recognition and initial management of ovarian cancer, in NICE clinical guidance 122, NICE.

[11]   Lim, A.W.W., et al. (2012) Predictive value of symptoms for ovarian cancer: Comparison of symptoms reported by questionnaire, interview, and general practitioner notes. Journal of the National Cancer Institute, 104, 114-124. doi:10.1093/jnci/djr486

[12]   Lurie, G., et al. (2009) Prediagnostic symptoms of ovarian carcinoma: A case-control study. Gynecologic Oncology, 114, 231-236. doi:10.1016/j.ygyno.2009.05.001

[13]   Goff, B.A., et al. (2007) Development of an ovarian cancer symptom index: Possibilities for earlier detection. Cancer, 109, 221-227. doi:10.1002/cncr.22371

[14]   Bankhead, C.R., et al. (2008) Identifying symptoms on ovarian cancer: A qualitative and quantitative study. Gynecologic Oncology, 115, 1008-1014.

[15]   Andersen, M.R., et al. (2008) Combining a symptoms index with CA125 to improve detection of ovarian cancer. Cancer, 113, 484-489. doi:10.1002/cncr.23577

[16]   Andersen, M.R., et al. (2010) Use of a symptom index, CA125, and HE4 to predict ovarian cancer. Gynecologic Oncology, 116, 378-383. doi:10.1016/j.ygyno.2009.10.087

[17]   Devlin, S.M., et al. (2010) Identification of ovarian cancer symptoms in health insurance claims data. Journal of Women’s Health, 19, 381-389.

[18]   Hippisley-Cox, J. and Coupland, C. (2012) Identifying women with suspected ovarian cancer in primary care: Derivation and validation of algorithm. British Medical Journal, 344, d8009. doi:10.1136/bmj.d8009

 
 
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