Three out of four women are diagnosed with ovarian cancer after the cancer has already spread elsewhere within the body. As this delay makes treatment more difficult, ovarian cancer charities are working hard to raise awareness so that the detection of the disease, treatment and survival prospects can be improved.
Unfortunately, delays in diagnosis of ovarian cancer are common and survival rates in the UK are particularly low compared to elsewhere in Europe. The likely causes are a lack of awareness of symptoms by women and the prompt management of the condition by GPs. Sometimes this may be due to women delaying seeing their GP when they have symptoms or because of their GP’s failure to recognise the potential importance of women’s reported symptoms such as persistent stomach pain and bloating.
Research published in 2012 by the Medical Defence Union (MDU), an insurer which represents doctors accused of negligence, identified that patients can experience a delay of up to several months before a GP or hospital doctor diagnoses the condition. Among the 290 complaints they examined over the period between 2002 to 2011, some women had been wrongly diagnosed with other conditions such as anaemia, diverticulitis and irritable bowel syndrome. The MDU said the research highlighted that ovarian cancer poses a “diagnostic challenge" to doctors because many of its symptoms are similar to those seen in other conditions.
In response to the poor survival statistics for ovarian cancer patients, the National Institute for Health and Clinical Excellence (NICE) produced guidelines in 2011 designed to improve diagnosis. One of these is that women aged over 50 who present with any of four major symptoms of ovarian cancer - pelvic or abdominal pain, persistent bloating, feeling full and/or loss of appetite, and increased urinary urgency and/or frequency - should automatically be referred for a CA125 blood test.
Commenting on Ovarian Cancer Awareness Month 2014, Lucie Prothero, associate in the clinical negligence team at Penningtons Manches LLP, said: “We wholeheartedly support the campaign of the UK’s ovarian cancer charities to heighten awareness of this disease which often results in sad outcomes. There is no doubt that ovarian cancer can represent a challenge to GPs, given that symptoms can be present in other, less sinister conditions. Often, however, basic blood tests, the recognition of continuing patterns of symptoms and prompt referral for gynecological opinion or radiology can make the difference between life and death.
“We deal with many enquiries from patients and their families who feel that an opportunity has been missed for an earlier diagnosis. It is fair to say that, in some cases, given the often non-specific nature of the symptoms, a failure to diagnose ovarian cancer is not necessarily negligent. However, ovarian cancer is so serious that any doctor considering it as a possible diagnosis should have a low threshold for referring a patient for further assessment, treatment or tests, especially if their patient’s symptoms do not improve. All too often we see the terrible outcome of delayed diagnosis of cancer when simple steps could have saved the patient’s life.”