Although they are not specific to ovarian cancer,such symptoms as abdominal swelling or pelvic pain could be early warnings, but physicians often do not order the tests needed to diagnose the disease until it is too late.

Only about one quarter of women with abdominal pain and swelling underwent pelvic imaging or other tests to diagnose ovarian cancer soon after complaining to their doctors of those symptoms, the researchers found.

Early Symptoms Often Present

Ovarian cancer is fast growing -- progressing from early to advanced disease in as little time as a year. There is increasing evidence that patients may exhibit symptoms many months before advanced disease and diagnosis occurs.

Lloyd H. Smith, MD, PhD, of the University of California Davis Medical Center in Sacramento and colleagues analyzed diagnostic records of 1,985 elderly women with ovarian cancer, 6,024 elderly women with localized breast cancer, and 10,941 age-matched Medicare-enrolled women without cancer.

They found that the women with ovarian cancer were at least twice as likely as those in the other two groups to present to a physician with abdominal swelling or pelvic pain as early as 12 months prior to diagnosis.

Women with ovarian cancer were more likely to complain of abdominal pain as early as nine months before diagnosis.

Diagnostic Pelvic Imaging

Overall, about 40 percent of women with ovarian cancer had physician claims indicating one or more visits for abdominal or pelvic symptoms between 36 and four months before their diagnosis, but only 25 percent of those patients had diagnostic pelvic imaging or CA125 serum tests during that period.

Most of them did receive abdominal imaging or diagnostic gastrointestinal studies, but those tests would have been less helpful in establishing the correct diagnosis.

More than half -- 54 percent -- of ovarian-cancer patients received pelvic imaging or CA125 serum testing within three months of their diagnosis.

"Our findings suggest that ovarian cancer could be diagnosed earlier in some patients whose diagnosis is currently delayed by at least four months because physicians order abdominal imaging or perform gastrointestinal procedures before they order a test more likely to diagnose ovarian cancer, such as pelvic imaging and/or CA125," conclude the authors.