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Frequency of Symptoms of Ovarian Cancer in Women Presenting to Primary Care Clinics
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Frequency of Symptoms of Ovarian Cancer in Women Presenting to Primary Care Clinics
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Exposure to tobacco smoke at a young age either by smoking or by being around people who smoke may be related to an increased breast cancer risk. Sixteen studies have examined smoking at a young age. These studies compared women who smoked at a young age to women who had never smoked or who were not currently smokers. Most studies reported a small increase in breast cancer risk associated with starting smoking under age 17. Two studies used women who were never passively exposed to tobacco smoke as the comparison group and found about a doubling of breast cancer risk among young smokers; one of the. | ORIGINAL CONTRIBUTION Frequency of Symptoms of Ovarian Cancer in Women Presenting to Primary Care Clinics Barbara A. Goff MD__ Lynn S. Mandel PhD Cindy H. Melancon RNỷ Howard G. Muntz MD 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. In fact textbooks in internal medicine family practice and even gynecology state that symptoms do not occur until the disease is advanced.1-4 However several retrospective studies have indicated that the majority of patients do have symptoms although not necessarily gynecologic in nature.5-9 These studies have been criticized because of small numbers of patients included and the retrospective chart analyses used for data collection. In a previous study we surveyed 1725 women with ovarian cancer.10 Surveys were returned from women in 46 states and 4 Canadian provinces. We found that 95 of women with ovarian cancer reported symptoms prior to diagnosis with the most common being abdominal 77 gastrointestinal tract 70 pain 58 constitutional 50 urinary 34 and pelvic 26 . Interestingly gynecologic symptoms were the least common of the major groups of symptoms. When we evaluated symptoms by stage of disease we found that in contrast to what is published in most textbooks 89 of women with stage I II disease reported symptoms prior to their diagnosis and 97 of those with ad- For editorial comment see p 2755. Context Women with ovarian cancer frequently report symptoms prior to diagnosis but distinguishing these symptoms from those that normally occur in women remains problematic. Objective To compare the frequency severity and duration of symptoms between women with ovarian cancer and women presenting to primary care clinics. Design Setting and Patients A prospective case-control study of women who visited 2 primary care clinics N 1709 and completed an anonymous survey of symptoms experienced over the past year July 2001-January
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