[Symptoms of ovarian cancer in young patients: a case control study in IRAN, 1998-2005]

ABSTRACT

Ovarian cancer is usually diagnosed after it has widely spread and is difficult to cure. Most of attempts to identify its early symptoms have either lacked a control group or have been based on interviews of patients with possible recall bias, and most studies have been performed on all age groups. To examine the early symptoms of ovarian cancer in young women aged between 15 and 35 compared with a matched control group. Hundred women with ovarian cancer were selected out of 565,611 women aging 15 to 35 years who were referred to Vali-Asr Gynecology Oncology Clinic of Imam Khomeini Hospital between 1998 and 2005. Symptoms of 100 cases were compared with those of 100 matched control women during one year before diagnosis. The proportion of cases who complained of at least one symptom up to one year before the diagnosis was significantly higher than controls, 95% versus 28%, respectively [p<0.05]. Most of these symptoms were abdominal in nature. Other symptoms included urinary problems, infertility and abnormal vaginal bleeding. The most common symptoms among cases were unusual abdominal or lower back pain [52%], unusual bloating, fullness and pressure in the abdomen [37%], gastro-intestinal problems [36%], and unusual lack of energy [22%]. The proportion of controls reporting these symptoms were 11%, 3%, 12% and 7%, respectively, resulting in odds ratios [95% confidence intervals] of 8.765 [4.18-18.355], 18.989 [5.614-64.228], 4.125 [1.991-8.546], and 3.747 [1.520-9.237] for these symptoms, respectively. There were only minor differences between cases with early and late stage disease. Unusual abdominal or lower back pain, unusual bloating, fullness and pressure, gastro-intestinal problems, frequent urination, urgency or burning, and infertility should make women and physicians more aware of possible changes associated with ovarian cancer in young women