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Predicting the value of indexing symptoms for ovarian cancer
Date:1/13/2012

ources, which had never been done before. Even so, they write that, "The small differences between the three indices indicate that there is little to gain from deriving new symptom indices." They also suggest that while a symptom index could advance the diagnosis of ovarian cancer, the benefits of such are greatly overemphasized, given that most symptoms of the disease emerge within three months before diagnosis. They write, "At best, a symptom index might advance diagnosis of ovarian cancer by 3 months or more in two-thirds of women. For a more specific index, the sensitivity would be approximately one-third."

In an accompanying editorial, Patricia Hartge, ScD, at National Cancer Institute's Division of Cancer Epidemiology and Genetics, and James L. Speyer, MD, from the NYU Langone Cancer Center, write that symptom indices such as the Goff index and two novel indices described in the study are viewed as good for detecting early-stage ovarian cancer with the assumption that an early detection and therapy can achieve a better patient outcome. While this can be true, they caution that these indices were not highly specific and that the screeners found the cancer symptoms close to the time in which the patient was diagnosed. "The study design permits no calculation of years of life that might have been saved or lost if screeners actually were usedonly a large and expensive randomized trial would do thatbut clinical gains likely would be minor, and many women would undergo unnecessary diagnostic procedures to assure that they are cancer free." They also point out that the difficulty of detecting ovarian cancer early persists for various reasons. "The biology of ovarian cancer, the arithmetic of screening, and the clinical characteristics of the disease and its treatment collude to make it difficult to find ovarian cancer early enough to matter."


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Contact: Zachary Rathner
Zachary.Rathner@oup.com
301-841-1286
Journal of the National Cancer Institute
Source:Eurekalert

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