We’re launching the latest addition to our Scottish GP toolkit, 10 top tips for GPs on ovarian cancer (PDF). Developed in collaboration with Macmillan Cancer Support, 10 top tips is a quick and easy way for all primary care health professionals practicing in Scotland to update their knowledge of ovarian cancer.
Why do we have a resource especially for Scotland?
In the past many GPs have held mistaken beliefs around the diagnosis of ovarian cancer, many of which continue to persist today. GPs in Scotland wrongly believe that ovarian cancer cannot be picked up early or does not have recognisable symptoms.
The answer also lays in the clinical guidance available for healthcare professionals in Scotland. At a quick glance the guidance available from the Scottish Intercollegiate Guidelines Network (SIGN) might appear to be the same as the guidance issued by the National Institute for Health and Care Excellence (NICE) for professionals practicing in England and Wales, but scratch the surface and there are striking differences:
Both SIGN and NICE guidance are clear that women visiting their GP or other primary care health professional, such as a GP nurse, with new onset ovarian cancer symptoms should be referred for diagnostic tests, but there is an important difference on how this should be done:
- Scottish guidance recommends an abdominal examination, and CA125 blood test and urgent pelvic ultrasound are carried out simultaneously. In contrast, guidance for England and Wales states that CA125 and urgent ultrasound are performed sequentially, with first the CA125 blood test and then an ultrasound if the CA125 level is raised.
- Scottish guidance then recommends an urgent referral to a gynae oncology specialist if CA125 is raised or the ultrasound is abnormal, whereas in England and Wales GPs are recommended to refer only after seeing an elevated CA125 and abnormal ultrasound.
These differences are subtle, but crucial, and could be significant in terms of early diagnosis. Diagnosis at the earliest possible stage is pivotal if we are to improve survival in Scotland, where nearly 600 women are diagnosed with ovarian cancer every year. Target Ovarian Cancer continues campaigning for better and more uniform ovarian cancer diagnosis guidelines across the UK.
Tools for GPs in Scotland
Target Ovarian Cancer’s GP toolkit is a resource that puts guidance at primary healthcare professionals’ fingertips. It contains information that will quickly and simply update knowledge of ovarian cancer, meaning that more people experiencing ovarian cancer symptoms will get on the correct diagnostic pathway. We also provide resources to help doctors and nurses chat with patients and get the most from a consultation. For an in-depth look at ovarian cancer we have developed online modules in collaboration with BMJ Learning and RCGP elearning.
Scotland has a strong track record in driving forward improvements for women diagnosed with ovarian cancer. It now has a great opportunity to strive to make advances in diagnosis, giving more women with ovarian cancer the best chance of an early diagnosis and for treatment to be effective.
Diagnosing ovarian cancer at the earliest possible stage is crucial, but improving outcomes for women is a multistep process which also requires gold standard treatment and cutting edge ovarian cancer drugs. The Scottish Medicines Consortium (SMC) is currently in the process of assessing a new drug called niraparib for use in NHS Scotland. We are following this development closely and will update our website and social media when we have more news.