Usefulness of abdominal symptoms in'early diagnosis

摘要

In contrastto.the predictable media coverage of Hamilton and colleagues' claims about early detection of ovarian cancer,1 general practitioners are crying out for reliable information on the predictive value of symptoms to enable early diagnosis and select patients for further investigation.One surprising omission from the study is a review of the community prevalence of the symptoms investigated. The prevalence of abdominal bloating in the control subjects was 2% (21 out of 1060 subjects). General practitioners active in clinical practice will find this surprisingly low, community surveys estimating it to be 16-30%. The positive predictive value for abdominal bloating that the authors calculate (0.3%) will be much lower if the prevalence of bloating is greater than the 2% in their controls.