Ovarian cancer prediction: development of a scoring system for primary care. Issue 8 (21st March 2013)

• Record Type: Journal Article
• Authors: Grewal, K; Hamilton, W; Sharp, D
• Is Part Of: BJOG. Volume 120:Issue 8(2013:Aug.)
• Page Start: 1016
• Page End: 1019
• Publication Date: 2013-03-21
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12200
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo12200-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12200-sec-0001" sec-type="section"> <title>Objective</title> <p>Recent studies have identified specific symptoms of ovarian cancer at all stages, raising the hope of reducing diagnostic delays. We aimed to devise a scoring system for symptoms of ovarian cancer in primary care.</p> </sec> <sec id="bjo12200-sec-0002" sec-type="section"> <title>Design</title> <p>Secondary analysis of data from a case–control study.</p> </sec> <sec id="bjo12200-sec-0003" sec-type="section"> <title>Setting</title> <p>Thirty‐nine general practices in Exeter, mid‐Devon and east Devon.</p> </sec> <sec id="bjo12200-sec-0004" sec-type="section"> <title>Population</title> <p>Two hundred and twelve women with ovarian cancer and 1060 age‐, sex‐ and practice‐matched controls.</p> </sec> <sec id="bjo12200-sec-0005" sec-type="section"> <title>Methods</title> <p>Conditional logistic regression was used to produce an additive scoring system and its receiver operator characteristic (ROC) curve. Several different cut‐offs were then tested using a simple costs model.</p> </sec> <sec id="bjo12200-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>The ROC curve value.</p> </sec> <sec id="bjo12200-sec-0007" sec-type="section"> <title>Results</title> <p>Each woman was assigned a score based on her symptoms in the year before diagnosis: we added a score for women aged ≥50 years, reflecting their increased incidence of ovarian cancer. The area under the ROC curve was 0.883 (95% confidence interval 0.853–0.912). The chosen cut‐off had a sensitivity of 72.6% and a specificity of 91.3%.</p> </sec> <sec id="bjo12200-sec-0008" sec-type="section"> <title>Conclusion</title> <p>This scoring system could potentially direct general practitioners to appropriate investigations for ovarian cancer on the basis of symptoms and save a substantial number of unnecessary ultrasound scans being requested.</p> </sec> </abstract>