to the editor
Study using data recorded through loyalty cards issued by high-street retailers provides useful information about buying pain relievers and treating indigestion[1]This allows for guesswork about the symptoms shoppers are experiencing and provides a lead time of up to eight months for an ovarian cancer diagnosis. This is somewhat longer than the lead time inferred by Hamilton et al. from the months of primary care visits prior to diagnosis.[2]The paper won the Royal College of General Practitioners Paper of the Year award.[3]We used a case-control analysis similar to a recent study.
The British Gynecologic Cancer Society has expressed concern about the UK’s performance in caring for patients with this condition, including delays in diagnosis[4]NICE guidance on ovarian cancer recognition and early management is to measure serum CA125 in primary care for women with symptoms suggestive of ovarian cancer. If serum CA125 is above her 35 IU/ml, the GP will arrange an ultrasound scan of the abdomen and pelvis, and if the ultrasound suggests ovarian cancer, urgently refer the woman for further investigation. is needed.[5]Requesting this blood test does not mean that you suspect ovarian cancer. This means that no urgent fast-track referral is needed based on these symptoms. Its purpose is to ensure that the diagnosis is not missed and to maximize the chances of getting the best possible outcome if the disease is indeed present. That’s it.
As the National Health Service, we need to make this test easier.Brewer at Al [1] “Monitoring such purchases may provide an opportunity for earlier diagnosis.” I don’t think it’s a viable approach. The findings only underscore the need to lower the threshold for doing blood tests.
References
1]Brewer HR, Hirst Y, Chadeau-Hyam M, Johnson E, Sundar S, Flanagan JM. Association of over-the-counter drug purchases with ovarian cancer diagnosis in the Cancer Loyalty Card Study (CLOCS): an observational case-control study. JMIR Public Health Survey 2023;9:e41762 doi: 10.2196/41762
2]Hamilton W, Peters TJ, Bankhead C, Sharp D. Ovarian cancer risk among symptomatic women in primary care: a population-based case-control study. BMJ 2009;339:b2998
3]BMJ 2010;340:c3286
4]Sundhar S et al, British Gynecological Cancer Society Recommendations for Evidence Based, Population Data Derived Quality Performance Indicators for Ovarian Cancer Cancers 2023, 15, 337. https://doi.org/10.3390/cancers15020337
5]National Institute of Health Care Excellence.Ovarian Cancer: Recognition and Initial Management Clinical Guidelines [CG122] 2011