Published 29 September 2009, doi:10.1136/bmj.b3954
Cite this as: BMJ 2009;339:b3954

Letters

Ovarian cancer

Usefulness of abdominal symptoms in early diagnosis

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

In contrast to the predictable media coverage of Hamilton and colleagues’ claims about early detection of ovarian cancer,¹ general practitioners are crying out for reliable information on the predictive value of symptoms to enable early diagnosis and select patients for further investigation.

One surprising omission from the study is a review of the community prevalence of the symptoms investigated. The prevalence of abdominal bloating in the control subjects was 2% (21 out of 1060 subjects). General practitioners active in clinical practice will find this surprisingly low, community surveys estimating it to be 16-30%.² The positive predictive value for abdominal bloating that the authors calculate (0.3%) will be much lower if the prevalence of bloating is greater than the 2% in their controls.

They state: "Women with ovarian cancer usually have symptoms and report them to primary care, sometimes months before diagnosis." But they found that women with ovarian cancer have . . . [Full text of this article]

¹ Munro Medical Centre, Spalding PE11 2BY

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Authors’ reply

William Hamilton, Tim J Peters, and Deborah Sharp
BMJ 2009 339: b4413. [Extract] [Full Text]

Risk of ovarian cancer in women with symptoms in primary care: population based case-control study

William Hamilton, Tim J Peters, Clare Bankhead, and Deborah Sharp
BMJ 2009 339: b2998. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Hamilton, W., Peters, T. J, Sharp, D. (2009). Authors' reply. BMJ 339: b4413-b4413 [Full text]  

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