[Ovarian cancer: the symptoms and pathology. The cases of the Cantonal Cancer Registry (1989-1995)].

Background: Ovarian cancer is most frequently discovered at an advanced stage. The absence of symptoms in the early stages is thought to be the main reason for this late discovery. We tried to determine whether there are any specific signs or symptoms for early or late stages.

Methods: From 1989 to 1995, the Cantonal Cancer Registry recorded 124 patients with ovarian cancer; 119 (96%) cases were evaluated. We defined signs and symptoms which led to the diagnosis, their histopathological properties and the medical specialty of the physician first consulted. The data were then analyzed for early stages (IA to IB) (n = 27) and advanced stages (IC to IV) (n = 92).

Results: In the early as well as late stages, the most common symptoms were abdominal pain (76%) and gastrointestinal problems (45%). Bladder and gynecological symptoms were rare (25% and 7% respectively). In the early stages, however, the ovarian tumor was larger (median size 14 vs 11 cm), there were more well differentiated tumors (48% G1 vs 25%) and the age was lower (median age 55 vs 66 years). The physician first consulted was a general practitioner in 2/3 (68%) of the cases and a gynecologist in 17%.

Conclusions: There are no specific ovarian carcinoma symptoms either in the early or in the late stages. The histology showed that tumors in the early stages were less aggressive and usually occurred in younger patients. The general practitioner was most often the first physician consulted by women suffering from ovarian cancer. General practitioners, therefore, should be specialists in the diagnosis of this disease, paying particular attention to women over 40 presenting with persistent abdominal pain.