Earlier diagnosis for ovarian cancer

Early diagnosis is a major focus of the work of Target Ovarian Cancer and we take a three-pronged approach to try and ensure that more women are diagnosed at an early stage when the cancer is still very treatable. Over 7000 women are diagnosed with ovarian cancer every year in the UK. Although fewer than half of women survive for longer than five years after diagnosis, this soars to 90 per cent of women whose tumours are detected early.

Firstly, we need to raise awareness among women themselves. Our ground-breaking Pathfinder research, which looked at ways to improve outcomes for women diagnosed with ovarian cancer, found that awareness of ovarian cancer symptoms among women is fairly low. There is also widespread confusion about cervical screening, which many people think checks for ovarian cancer as well. In fact, it only checks for mutations in cells in the cervix which may indicate cervical cancer.

Symptoms of ovarian cancer  may be dismissed or confused with other problems, including irritable bowel syndrome (IBS), but there are four key red flags which point to ovarian cancer: persistent bloating, feeling full quickly and/or loss of appetite, pelvic or abdominal pain, and urinary symptoms. Guidelines are also clear that symptoms that could indicate new onset IBS in women over 50, should trigger a referral for testing for ovarian cancer. The Government-funded Be Clear on Cancer campaign which has been running for the past few years has not yet focused on ovarian cancer specifically and this is something Target Ovarian Cancer is campaigning on at the moment.

Secondly, GPs need to be aware of the symptoms and the appropriate referral process if they suspect a woman may have tell-tale signs of the disease.  NICE guidelines for diagnosing and treating ovarian cancer were introduced in 2011, which is relatively recent and many GPs have received little training on the signs and symptoms of ovarian cancer at medical school. Target Ovarian Cancer now produces a symptoms diary [https://www.targetovariancancer.org.uk/information-and-support/what-ovarian-cancer/symptoms/ovarian-cancer-symptoms-diary] which women who are concerned can complete and show to their GP to help them diagnose the condition more promptly. We do a lot of work with GPs at a grassroots level to share information and guidelines and also encourage GPs to think about the possibility that a woman may have ovarian cancer when presenting with some typical symptoms of IBS, like bloating and pain.

Thirdly, we need to make sure that the diagnostic pathway works and is as efficient as possible. With regards to the current pathway, we have heard that it can take a long time for labs to send back blood tests and labs will send blood samples back if paperwork is not correct. There is also a lot of ‘bounce back’ as current referral pathways require GPs to pick an option, refer to secondary care and if tests down that route prove inconclusive, refer again down another pathway. An approach which may work well in the UK is one that is already up and running in Denmark which has a similar GP model to our own. There, patients can be referred to multidisciplinary diagnostic centres where a range of different diagnostic tests can be done at the same time until the experts have the correct answer. These are now being piloted at sites in England and Wales.

At the moment, the new Cancer Strategy has outlined a target that 95 per cent of cases of cancer should be diagnosed within 28 days of a patient presenting at his or her doctor. Sadly, this is unlikely to be achievable for ovarian cancer unless action is taken to shorten the current diagnostic pathway.

We’ve come far, but we have a long way to go – that’s why Target Ovarian Cancer launched their recent TAKE OVAR campaign to raise awareness, fund research – and ultimately save lives. Together we can make sure women in the UK have the best chances of survival.