Abstract
Purpose The objective of this study was to investigate the
outcome of the urgent referrals with suspected gynaecological
malignancy.
Methods Retrospective analysis of the data of the urgent
referrals for suspected gynaecological cancers over a
12-month period at a gynaecological oncology cancer
centre in the UK.
Results A total of 233 patients (70.61%) were referred
with suspected endometrial pathology, 59 patients
(17.88%) with suspected ovarian, 25 patients (7.58%) with
suspected cervical and 13 patients (3.94%) with suspected
vulval malignancy. The positive predictive value of referrals
for diagnosing endometrial, ovarian, cervical and
vulval malignancy was 11.6, 23.7, 12.0 and 15.4%,
respectively. Amongst the indications for referral for suspected
endometrial cancer, presence of postmenopausal
vaginal bleeding had the higher odds for cancer
(odds = 0.13; 95% CI 0.08–0.21). The odds for cancer for
women referred with a pelvic mass was 0.17 (95% CI,
0.07–0.42) and for women referred with abdominal
bloating was 0.66 (95% CI, 0.18–2.36). All the cases of
malignancy were diagnosed in women referred with suspicious
appearance of the cervix on clinical examination.
The odds for cancer was 0.50 if the indication for referral
was vulval itching. The majority of cases of gynaecological
cancers during the study period were diagnosed following
routine referrals.
Conclusion The overall predictive value of two-week
wait referrals for suspected gynaecological malignancies is
low. Refinement of the current referral guidelines is
required with particular emphasis in the premenopausal
women where the diagnostic performance
Original language | English |
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Pages (from-to) | 1495-1500 |
Number of pages | 6 |
Journal | Archives of Gynecology and Obstetrics |
Volume | 284 |
Issue number | 6 |
DOIs | |
Publication status | Published - 2011 |