Detecting ovarian cancer in primary care: can we do better?

[摘要] The NHS Long Term Plan sets a target of detecting three-quarters of cancers at an early stage (I–II) by 2028.1 Currently, fewer than half of UK women with ovarian cancer are diagnosed at an early stage.In 2021 the results of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) were published.2 Disappointingly, this landmark trial showed no reduction in mortality through screening. Even if a promising new screening approach were developed today, the time needed to rigorously evaluate tests and pathways means we are unlikely to see an evidence-based ovarian cancer screening programme implemented within the next decade. In the absence of screening, most women will continue to be diagnosed following the onset of symptoms. Ensuring primary care assessment, triage, and specialist referral is as accurate and timely as possible is key to reducing diagnostic delay and optimising outcomes.THE CHALLENGE Ovarian cancer is the sixth most common cancer and the sixth most common cause of cancer death in UK women.3 Most are not diagnosed until the cancer is advanced, which contributes to the poor outcomes, including the 5-year net survival of 43%.4 Earlier detection could enable more women to be diagnosed with more treatable disease.Symptoms can occur in both early- and late-stage disease,5 but these are generally non-specific posing a diagnostic challenge. In the UK, one-third of women present to primary care with relevant symptoms three or more times before specialist referral, and one-quarter take ≥160 days to be diagnosed following presentation.

[学科分类] 卫生学