Ovarian cancer: Step closer to national guidelines

29^th September 2010 - For the first time, national guidelines are being developed for the NHS in England and Wales to aid earlier diagnosis - and promote more effective management - for women with ovarian cancer.

Ovarian cancer is the fifth most common cancer in women with around 6,800 cases being diagnosed each year in the UK.

Now the health watchdog, The National Institute for Health and Clinical Excellence (NICE), has issued draft guidance to the NHS listing the symptoms GPs should look out for.

Key symptoms:

• Persistent pelvic and abdominal pain
• Increased abdominal size/persistent bloating - not bloating that comes and goes
• Difficulty eating, and feeling full quickly

There are certain risk factors that may increase a woman’s chances of developing ovarian cancer.

These include:

• Getting older
• A family history of ovarian and/or breast cancer
• Not having children
• Hormone Replacement Therapy (HRT)
• Being overweight

The risk of ovarian cancer is lower in women who have:

• Taken the contraceptive pill
• Had children
• Breastfed their children
• Had their ‘tubes tied’ (tubal ligation) or had a hysterectomy

Attempting to Increase survival rates

Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE and a practising oncologist, said in a press release: “Overall survival rates for ovarian cancer are low - only around one in three women will live for at least five years after diagnosis. This is mainly because women who develop ovarian cancer and their GPs often only realise something may be seriously wrong when the cancer is advanced.

“Women can also experience delays between visiting their GP, seeing a specialist, getting a diagnosis and receiving treatment. This guideline will seek to overcome these hurdles to ensure women receive a diagnosis and subsequent treatment in a more timely manner.

“The earlier the cancer is identified, the more likely treatment is to be successful because it tackles the disease at a less advanced stage.”

Draft guidance

NICE, which is developing this guidance, is publishing its draft recommendations for consultation. Charities, patient groups, NHS organisations and others who have registered an interest in these guidelines, now have the opportunity to provide feedback on the proposed recommendations to help develop them further, ahead of the final guidelines being published next year.

The draft guidelines focus on the signs and symptoms of ovarian cancer, how best to detect the disease in a primary care setting (e.g. GP surgery), the most effective ways to establish a diagnosis and treat both early and advanced disease, and providing effective support and information to women who have been newly diagnosed.

Charity response

Frances Reid, Director of Public Affairs for the charity Target Ovarian Cancer, is part of a group of experts who are helping to develop the NICE guidelines. She said in a press release: “The development of this guidance by NICE is a major step forward. Never again should ovarian cancer be called a 'silent killer'. The guidance, backed by a robust evidence base has the potential to help GPs make informed decisions about referrals and tests using up to date knowledge, and women understand when they should seek medical help.