Ovarian cancer is often classified as a gynaecological cancer, but the main symptoms are abdominal. At Target Ovarian Cancer, we're urging clinicians to recognise that ovarian cancer presents as an abdominal cancer.
Primary Care Advisory Board and Target Ovarian Cancer GP Ambassador Dr Victoria Barber says:
Ovarian cancer does not present as a gynaecological cancer. It is vital that GPs, physicians' associates, practice nurses – the whole primary care team – recognises that any abdominal symptoms could equal ovarian cancer.
Speaking at the Primary Care and Public Health conference at the NEC in Birmingham on 18 May, Dr Barber set out her stall early; addressing the busy hall in the Women’s Health Theatre with a presentation which immediately grabbed the audience’s attention ‘Ovarian cancer: An abdominal cancer’.
Dr Kevin Barrett underlined Dr Barber’s key message in his own presentation to GPs ‘A user-friendly guide to IBS management in primary care’, emphasising ovarian cancer as a differential diagnosis with bowel disorders.
From the moment that Dr Barber’s talk ended, Target Ovarian Cancer’s stand was inundated with delegates who had felt the full impact of her words. One primary care clinician commented: “I’m thinking back to all the women I’ve seen with IBS who I might have missed as potentially having ovarian cancer.”
This shift in understanding of the disease – from a gynaecological to an abdominal cancer – prompted many clinicians to ask questions, ask for more information, and find out how the charity could support them in diagnosing more women faster and earlier.
A recent Target Ovarian Cancer project trialled three primary care interventions to improve early diagnosis of the disease - a clinical IT alert tool, a retrospective audit search and safety netting search.
They assist primary care teams to act confidently on possible ovarian cancer symptoms; to recall women with possible ovarian cancer symptoms who have not had a CA125 blood test; and to safety net women who have persistent symptoms but whose CA125 blood test results and ultrasound scan are reported as normal.
Two of these interventions specifically target women with abdominal symptoms. The IT alert is one that comes up on screen with advice to test CA125 and review NICE guidance when a woman over 50 is coded with a new diagnosis of IBS or diverticulitis and there has been no recent CA125.
The retrospective audit consists of an audit search that brings up a list of women coded with a new diagnosis of IBS or diverticulitis in the last six months, with no recent CA125 result. In the pilot, those women were called by physicians associates and invited to undergo the test. The practices taking part reported that patients were keen to undertake the test and be checked.
Ovarian cancer symptoms recognition and diagnosis could be transformed with this simple change in perception – from a gynaecological cancer to an abdominal cancer.
