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Detection of early stage ovarian cancer in a large community cohort

BACKGROUND: Although detecting ovarian cancer at early stage is a highly meaningful clinical goal, no studies have evaluated early stage disease presentation in a large community‐based population and how it differs from that of late stage disease. METHODS: Electronic medical records were evaluated f...

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Autores principales: Suh‐Burgmann, Elizabeth J., Alavi, Mubarika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853807/
https://www.ncbi.nlm.nih.gov/pubmed/31568690
http://dx.doi.org/10.1002/cam4.2522
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author Suh‐Burgmann, Elizabeth J.
Alavi, Mubarika
author_facet Suh‐Burgmann, Elizabeth J.
Alavi, Mubarika
author_sort Suh‐Burgmann, Elizabeth J.
collection PubMed
description BACKGROUND: Although detecting ovarian cancer at early stage is a highly meaningful clinical goal, no studies have evaluated early stage disease presentation in a large community‐based population and how it differs from that of late stage disease. METHODS: Electronic medical records were evaluated for women diagnosed with ovarian or fallopian tube cancer in 2016 and 2017 to identify the first imaging study to detect disease. Women being followed prior to diagnosis for known genetic risk from BRCA or other mutation were excluded. The visit in which the imaging test was ordered and related encounters were reviewed to determine the indication for imaging. Patient characteristics, presenting symptoms and duration, and modality of first abnormal imaging were compared for early vs late stage ovarian cancer and by provider specialty. RESULTS: Of 540 women with ovarian cancer, 190 (35%) were diagnosed with early stage disease, of whom 141 (74%) were symptomatic, with 45% of women presenting to internists, 33% to gynecologists, and 20% to emergency medicine physicians. Pelvic ultrasonography detected only 23% of late stage cases whereas pelvic ultrasonography and abdominal pelvic computed tomography (CT) each detected 47% of early stage cases. While abdominal pain and bloating were common to both women with early and late stage cancer, women with early stage disease were younger (58 vs 64 years, P < .0001), more likely to present to gynecologists (33% vs 15%, P < .001) and complained more often of a palpable mass (17% vs 6%, P < .0001) or postmenopausal bleeding (11% vs 5%, P < .001). CONCLUSIONS: Excluding women with genetic predisposition to ovarian cancer known prior to diagnosis, approximately three out of four cases of early stage ovarian cancer are detected as the result of evaluation of symptoms and one in four cases are detected incidentally. Abdominal pelvic CT and pelvic ultrasonography each detect an equal proportion of early stage cases. In contrast to late stage presentation, women diagnosed with early stage disease present more often with complaints of a palpable mass or postmenopausal bleeding, particularly to gynecologists.
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spelling pubmed-68538072019-12-16 Detection of early stage ovarian cancer in a large community cohort Suh‐Burgmann, Elizabeth J. Alavi, Mubarika Cancer Med Cancer Prevention BACKGROUND: Although detecting ovarian cancer at early stage is a highly meaningful clinical goal, no studies have evaluated early stage disease presentation in a large community‐based population and how it differs from that of late stage disease. METHODS: Electronic medical records were evaluated for women diagnosed with ovarian or fallopian tube cancer in 2016 and 2017 to identify the first imaging study to detect disease. Women being followed prior to diagnosis for known genetic risk from BRCA or other mutation were excluded. The visit in which the imaging test was ordered and related encounters were reviewed to determine the indication for imaging. Patient characteristics, presenting symptoms and duration, and modality of first abnormal imaging were compared for early vs late stage ovarian cancer and by provider specialty. RESULTS: Of 540 women with ovarian cancer, 190 (35%) were diagnosed with early stage disease, of whom 141 (74%) were symptomatic, with 45% of women presenting to internists, 33% to gynecologists, and 20% to emergency medicine physicians. Pelvic ultrasonography detected only 23% of late stage cases whereas pelvic ultrasonography and abdominal pelvic computed tomography (CT) each detected 47% of early stage cases. While abdominal pain and bloating were common to both women with early and late stage cancer, women with early stage disease were younger (58 vs 64 years, P < .0001), more likely to present to gynecologists (33% vs 15%, P < .001) and complained more often of a palpable mass (17% vs 6%, P < .0001) or postmenopausal bleeding (11% vs 5%, P < .001). CONCLUSIONS: Excluding women with genetic predisposition to ovarian cancer known prior to diagnosis, approximately three out of four cases of early stage ovarian cancer are detected as the result of evaluation of symptoms and one in four cases are detected incidentally. Abdominal pelvic CT and pelvic ultrasonography each detect an equal proportion of early stage cases. In contrast to late stage presentation, women diagnosed with early stage disease present more often with complaints of a palpable mass or postmenopausal bleeding, particularly to gynecologists. John Wiley and Sons Inc. 2019-09-30 /pmc/articles/PMC6853807/ /pubmed/31568690 http://dx.doi.org/10.1002/cam4.2522 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cancer Prevention
Suh‐Burgmann, Elizabeth J.
Alavi, Mubarika
Detection of early stage ovarian cancer in a large community cohort
title Detection of early stage ovarian cancer in a large community cohort
title_full Detection of early stage ovarian cancer in a large community cohort
title_fullStr Detection of early stage ovarian cancer in a large community cohort
title_full_unstemmed Detection of early stage ovarian cancer in a large community cohort
title_short Detection of early stage ovarian cancer in a large community cohort
title_sort detection of early stage ovarian cancer in a large community cohort
topic Cancer Prevention
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853807/
https://www.ncbi.nlm.nih.gov/pubmed/31568690
http://dx.doi.org/10.1002/cam4.2522
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