This is well worth a read – it changes our way of investigating women with abdominal symptoms quite a lot. Using our current system, most women are diagnosed at a late stage, so we need to do something different.
The basis of this guideline is:
1) Identify women
- Women over 50 who have had symptoms in the last 12m suggestive of IBS.
- Women who have unexplained weight loss, change in bowels or fatigue and where ovarian cancer is suspected.
- Women who fit the ‘Goff Index’ for their symptoms:
- Any of the following symptoms at least 12 times a month (present for less than one year):
- Pelvic / abdo pain
- Urinary frequency / urgency
- Increased abdo size / bloating
- Difficult eating / feeling full
Of these women, only 0.23% (1 in 500) will turn out to have ovarian cancer. We don’t have a brilliant screening test, so we have to rationalise what we do at the moment. It is recognised that the following process will miss some women, but if all women are advised to return if symptoms become frequent or persistent, then the few who are missed, should re-present