Recognition and initial management of ovarian cancer: summary of NICE guidance

Ovarian cancer is the leading cause of death from gynaecological cancer in the United Kingdom, and its incidence is rising. It is the fifth most common cancer in women, with a lifetime risk of about 2% in England and Wales.1 The outcome for women with ovarian cancer is generally poor, with an overall five year survival rate of less than 35%.2 Most women have had symptoms for months before presentation, and as these are frequently non-specific, delays often occur between presentation and referral to a specialist.3 Greater awareness of the disease and appropriate initial investigations in primary and secondary care are needed to enable earlier referral and optimum treatment. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on the recognition and initial management of women with ovarian cancer.4 NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Detection in primary care #### Awareness of symptoms and signs