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SINCE symptoms aren’t always noticeable until later in the disease’s progress and routine screening for women with no symptoms or risk factors has been unreliable, ovarian cancer — which is among the five leading causes of death in women — is difficult to detect in its early stages, says the April 2013 issue of the Johns Hopkins’ Medicine HealthAfter 50.

The U.S. Preventive Services Task Force, a federal advisory panel of health experts, recommends against annual screening for women at low or moderate risk because of unacceptably high rates of false-positive results.

However, the health letter offers a list of certain seemingly harmless or vague warning signs which may indicate the possibility of cancer:

• Bloating

• Increased abdominal girth

• Pelvic pain

• Abdominal pain

• Difficulty eating

• Feeling full quickly

If the disease has spread beyond the ovaries, symptoms such as frequent urination, urinary urgency, unexplained vaginal bleeding, fatigue and shortness of breath, are more likely to occur.

It is important to let your primary health-care physician or gynecologist know, if you experience any of the warning signs or symptoms mentioned above — whether they are new to you or you’ve experienced them for a prolonged period — so he/she can determine whether testing for the presence of ovarian cancer is warranted.

While having these symptoms doesn’t necessarily mean you have cancer, many women do not bring them up during their visit to the doctor because these symptoms are common to other conditions.

A new study from the Fred Hutchinson Cancer Research Center in Seattle, which appeared in the September 2012 Open Journal of Obstetric and Gynecology suggests that gynecologists can identify women who need further evaluation by having their patients complete a simple questionnaire that asks about these early warning signs — evidence cited in the study showed that 57 percent of women with early-stage ovarian cancer and 80 percent with advanced cancer experience some of these warning signs and symptoms.

Unfortunately, according to a 2007 study in Cancer, more than 70 percent of women with ovarian cancer are diagnosed when the disease is in its advanced stages, when survival rates are grim — only 20 to 30 percent are still alive after five years.

However, when the disease is found early and hasn’t spread beyond the ovary, the survival rate is 70 to 90 percent.

Thus, doctors can decide who are candidates for additional screening and potentially diagnose women whose cancer may have otherwise gone undetected until the later stages, when symptoms are more prominent and survival rates are low.

Although it’s known that ovarian cancer is most common in white menopausal women and, according to the American Cancer Society, more than half are diagnosed when they’re age 60 or older, experts still don’t know why some women get ovarian cancer and others don’t.

Nevertheless, you’re considered at risk if you:

• Have a family history of ovarian, breast, endometrial or colorectal cancer

• Carry a BRCA gene mutation

• Have Lynch syndrome, an inherited condition caused by gene mutations that predispose individuals to a high risk of colorectal cancer

Other possible risk factors, identified in several studies, may put you at increased risk (but not high), if you:

• Have never been pregnant

• Have a history of infertility

• Have had endometriosis

• Took or are taking menopausal hormone therapy

• Have a personal or family history of breast or uterine cancer

• Are obese

While experts don’t recommend routine ovarian cancer screening for women of average risk, two major medical societies, the American Cancer Society and the American Congress of Obstetricians and Gynecologists, suggest that routine screening with a blood test or pelvic ultrasound (or a combination of the two) may be appropriate for some women considered at risk for developing ovarian cancer (as described above), concludes the health letter.