B-QuiCK: Ovarian cancer

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B-QuiCK: Ovarian cancer – early detection and referral

  • Epithelial ovarian cancer is the most common type of ovarian cancer; the majority of these are high-grade serous carcinomas that usually originate in the fimbria portion of the fallopian tubes. High-grade serous carcinomas grow quickly and spread early, therefore are usually diagnosed at a late stage where prognosis is poor. Early detection is more likely in females with other subtypes of epithelial ovarian cancer where growth is slower.
  • There are no screening programmes available or recommended for the early detection of ovarian cancer, so diagnosis relies on recognising and investigating suspicious symptoms which are often non-specific in isolation
    • Symptoms may include abdominal or pelvic pain, abdominal bloating or distention, early satiety or loss of appetite, increased urinary frequency or urgency, changes in bowel habit, fatigue, unexplained weight loss, post-menopausal bleeding
    • There should be a higher suspicion of ovarian cancer for a patient who is post-menopausal and/or if symptoms are new, severe, unusual, recurrent or persistent, e.g. occurring at least 12 days per month
    • Consider incorporating education about the key symptoms of ovarian cancer during relevant discussions to minimise delayed presentation and to improve the likelihood of early detection

Some females with a personal or family history of cancer (e.g. breast, ovarian, endometrial, colorectal) or a known cancer gene mutation in a blood relative (e.g. BRCA1/2) may be eligible for, and benefit from, genetic testing. Check local HealthPathways to assess eligibility criteria for referral to Genetic Health Service New Zealand.

Patients with suspicion of ovarian cancer

*Avoid measuring CA 125 during menstruation if possible. Also measure human chorionic gonadotrophin and alpha fetoprotein if a patient is pre-menopausal.

Should include transvaginal ultrasound

Figure 4. A suggested approach to the diagnosis of ovarian cancer.

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