Variation in the initial assessment and investigation for ovarian cancer in symptomatic women: a systematic review of international guidelines

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Variation in the initial assessment and investigation for ovarian cancer in symptomatic women : a systematic review of international guidelines. / Funston, Garth; Van Melle, Marije; Baun, Marie-Louise Ladegaard; Jensen, Henry; Helsper, Charles; Emery, Jon; Crosbie, Emma J; Thompson, Matthew; Hamilton, Willie; Walter, Fiona M.

I: BMC Cancer, Bind 19, Nr. 1, 1028, 01.11.2019.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisReviewForskningpeer review

Harvard

Funston, G, Van Melle, M, Baun, M-LL, Jensen, H, Helsper, C, Emery, J, Crosbie, EJ, Thompson, M, Hamilton, W & Walter, FM 2019, 'Variation in the initial assessment and investigation for ovarian cancer in symptomatic women: a systematic review of international guidelines', BMC Cancer, bind 19, nr. 1, 1028. https://doi.org/10.1186/s12885-019-6211-2

APA

Funston, G., Van Melle, M., Baun, M-L. L., Jensen, H., Helsper, C., Emery, J., Crosbie, E. J., Thompson, M., Hamilton, W., & Walter, F. M. (2019). Variation in the initial assessment and investigation for ovarian cancer in symptomatic women: a systematic review of international guidelines. BMC Cancer, 19(1), [1028]. https://doi.org/10.1186/s12885-019-6211-2

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MLA

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Author

Funston, Garth ; Van Melle, Marije ; Baun, Marie-Louise Ladegaard ; Jensen, Henry ; Helsper, Charles ; Emery, Jon ; Crosbie, Emma J ; Thompson, Matthew ; Hamilton, Willie ; Walter, Fiona M. / Variation in the initial assessment and investigation for ovarian cancer in symptomatic women : a systematic review of international guidelines. I: BMC Cancer. 2019 ; Bind 19, Nr. 1.

Bibtex

@article{82bba3ad6fa54426aca670fc36b2b522,
title = "Variation in the initial assessment and investigation for ovarian cancer in symptomatic women: a systematic review of international guidelines",
abstract = "BACKGROUND: Women with ovarian cancer can present with a variety of symptoms and signs, and an increasing range of tests are available for their investigation. A number of international guidelines provide advice for the initial assessment of possible ovarian cancer in symptomatic women. We systematically identified and reviewed the consistency and quality of these documents.METHODS: MEDLINE, Embase, guideline-specific databases and professional organisation websites were searched in March 2018 for relevant clinical guidelines, consensus statements and clinical pathways, produced by professional or governmental bodies. Two reviewers independently extracted data and appraised documents using the Appraisal for Guidelines and Research Evaluation 2 (AGREEII) tool.RESULTS: Eighteen documents from 11 countries in six languages met selection criteria. Methodological quality varied with two guidance documents achieving an AGREEII score ≥ 50% in all six domains and 10 documents scoring ≥50% for {"}Rigour of development{"} (range: 7-96%). All guidance documents provided advice on possible symptoms of ovarian cancer, although the number of symptoms included in documents ranged from four to 14 with only one symptom (bloating/abdominal distension/increased abdominal size) appearing in all documents. Fourteen documents provided advice on physical examinations but varied in both the examinations they recommended and the physical signs they included. Fifteen documents provided recommendations on initial investigations. Transabdominal/transvaginal ultrasound and the serum biomarker CA125 were the most widely advocated initial tests. Five distinct testing strategies were identified based on the number of tests and the order of testing advocated: 'single test', 'dual testing', 'sequential testing', 'multiple testing options' and 'no testing'.CONCLUSIONS: Recommendations on the initial assessment and investigation for ovarian cancer in symptomatic women vary considerably between international guidance documents. This variation could contribute to differences in the way symptomatic women are assessed and investigated between countries. Greater research is needed to evaluate the assessment and testing approaches advocated by different guidelines and their impact on ovarian cancer detection.",
keywords = "Cancer biomarkers, Cancer detection, Cancer pathways, Clinical guidelines, Ovarian cancer, Ovarian cancer signs, Ovarian cancer symptoms, Ovarian cancer tests, Primary care, Symptom-triggered testing",
author = "Garth Funston and {Van Melle}, Marije and Baun, {Marie-Louise Ladegaard} and Henry Jensen and Charles Helsper and Jon Emery and Crosbie, {Emma J} and Matthew Thompson and Willie Hamilton and Walter, {Fiona M}",
year = "2019",
month = nov,
day = "1",
doi = "10.1186/s12885-019-6211-2",
language = "English",
volume = "19",
journal = "B M C Cancer",
issn = "1471-2407",
publisher = "BioMed Central Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - Variation in the initial assessment and investigation for ovarian cancer in symptomatic women

T2 - a systematic review of international guidelines

AU - Funston, Garth

AU - Van Melle, Marije

AU - Baun, Marie-Louise Ladegaard

AU - Jensen, Henry

AU - Helsper, Charles

AU - Emery, Jon

AU - Crosbie, Emma J

AU - Thompson, Matthew

AU - Hamilton, Willie

AU - Walter, Fiona M

PY - 2019/11/1

Y1 - 2019/11/1

N2 - BACKGROUND: Women with ovarian cancer can present with a variety of symptoms and signs, and an increasing range of tests are available for their investigation. A number of international guidelines provide advice for the initial assessment of possible ovarian cancer in symptomatic women. We systematically identified and reviewed the consistency and quality of these documents.METHODS: MEDLINE, Embase, guideline-specific databases and professional organisation websites were searched in March 2018 for relevant clinical guidelines, consensus statements and clinical pathways, produced by professional or governmental bodies. Two reviewers independently extracted data and appraised documents using the Appraisal for Guidelines and Research Evaluation 2 (AGREEII) tool.RESULTS: Eighteen documents from 11 countries in six languages met selection criteria. Methodological quality varied with two guidance documents achieving an AGREEII score ≥ 50% in all six domains and 10 documents scoring ≥50% for "Rigour of development" (range: 7-96%). All guidance documents provided advice on possible symptoms of ovarian cancer, although the number of symptoms included in documents ranged from four to 14 with only one symptom (bloating/abdominal distension/increased abdominal size) appearing in all documents. Fourteen documents provided advice on physical examinations but varied in both the examinations they recommended and the physical signs they included. Fifteen documents provided recommendations on initial investigations. Transabdominal/transvaginal ultrasound and the serum biomarker CA125 were the most widely advocated initial tests. Five distinct testing strategies were identified based on the number of tests and the order of testing advocated: 'single test', 'dual testing', 'sequential testing', 'multiple testing options' and 'no testing'.CONCLUSIONS: Recommendations on the initial assessment and investigation for ovarian cancer in symptomatic women vary considerably between international guidance documents. This variation could contribute to differences in the way symptomatic women are assessed and investigated between countries. Greater research is needed to evaluate the assessment and testing approaches advocated by different guidelines and their impact on ovarian cancer detection.

AB - BACKGROUND: Women with ovarian cancer can present with a variety of symptoms and signs, and an increasing range of tests are available for their investigation. A number of international guidelines provide advice for the initial assessment of possible ovarian cancer in symptomatic women. We systematically identified and reviewed the consistency and quality of these documents.METHODS: MEDLINE, Embase, guideline-specific databases and professional organisation websites were searched in March 2018 for relevant clinical guidelines, consensus statements and clinical pathways, produced by professional or governmental bodies. Two reviewers independently extracted data and appraised documents using the Appraisal for Guidelines and Research Evaluation 2 (AGREEII) tool.RESULTS: Eighteen documents from 11 countries in six languages met selection criteria. Methodological quality varied with two guidance documents achieving an AGREEII score ≥ 50% in all six domains and 10 documents scoring ≥50% for "Rigour of development" (range: 7-96%). All guidance documents provided advice on possible symptoms of ovarian cancer, although the number of symptoms included in documents ranged from four to 14 with only one symptom (bloating/abdominal distension/increased abdominal size) appearing in all documents. Fourteen documents provided advice on physical examinations but varied in both the examinations they recommended and the physical signs they included. Fifteen documents provided recommendations on initial investigations. Transabdominal/transvaginal ultrasound and the serum biomarker CA125 were the most widely advocated initial tests. Five distinct testing strategies were identified based on the number of tests and the order of testing advocated: 'single test', 'dual testing', 'sequential testing', 'multiple testing options' and 'no testing'.CONCLUSIONS: Recommendations on the initial assessment and investigation for ovarian cancer in symptomatic women vary considerably between international guidance documents. This variation could contribute to differences in the way symptomatic women are assessed and investigated between countries. Greater research is needed to evaluate the assessment and testing approaches advocated by different guidelines and their impact on ovarian cancer detection.

KW - Cancer biomarkers

KW - Cancer detection

KW - Cancer pathways

KW - Clinical guidelines

KW - Ovarian cancer

KW - Ovarian cancer signs

KW - Ovarian cancer symptoms

KW - Ovarian cancer tests

KW - Primary care

KW - Symptom-triggered testing

U2 - 10.1186/s12885-019-6211-2

DO - 10.1186/s12885-019-6211-2

M3 - Review

C2 - 31676000

VL - 19

JO - B M C Cancer

JF - B M C Cancer

SN - 1471-2407

IS - 1

M1 - 1028

ER -