ABSTRACT

Ovarian cancer continues to frustrate. Clinicians are disadvantaged by the characteristics of unreliable, inconsistent symptomatology, which accounts for late presentation and poorly associated survival figures. Even when the patient does present early, the preoperative diagnosis of ovarian cancer is frequently a difficult one to make. This is borne out by the fact that 50% of patients with this disease are initially referred to general physicians or general surgeons for investigation of symptomatology or ascites. The development by Jacobs et al. (1990) of a scoring system, the risk of malignancy index, which incorporates the use of the serum CA125 level, pelvic ultrasound features, and the menopausal status of the patient, has greatly eased this preoperative diagnosing difficulty.