Published 28 October 2009, doi:10.1136/bmj.b4413
Cite this as: BMJ 2009;339:b4413

Letters

Ovarian cancer

Authors’ reply

The first 150 words of the full text of this article appear below.

We are glad Wheatley agrees that general practitioners would appreciate reliable information on the predictive values of symptoms of ovarian cancer—that is what our study set out to do.^{1 2} He is concerned about the non-specific nature of the symptoms we identified. It certainly would be simpler if there were a symptom with high sensitivity and specificity for ovarian cancer, but none exists.

Mourits and de Bock bring a lot of experience of ovarian cancer screening to bear on this problem.³ They state, without a supporting reference, that "we can only diagnose ovarian cancers at an advanced stage." This is not so. Table 2 in our paper shows that women with early cancers have more symptoms than controls.² After all, the 53 women in this study with stages I-II cancer (from 212 in total) were diagnosed symptomatically—no other diagnostic route existed at the time. This is not to say clinical diagnosis . . . [Full text of this article]

¹ NIHR School for Primary Care Research, Department of Community Based Medicine, University of Bristol, Bristol BS8 2AA

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