title: Views of general practitioners on the role of CA125 in primary care to diagnose ovarian cancer.
abstract: BACKGROUND
  NICE guidance on the investigation and treatment of ovarian cancer advocates that the tumour marker CA125 should be the first line investigation for women suspected of having ovarian cancer.
  
  
  METHODS
  An internet-based survey, of primary care doctors in the West Midlands, was conducted in order to ascertain the views of general practitioners (GPs) of NICE guidance on the use of CA125 to triage suspected ovarian cancer cancers and the impact that this may have on referral pathways.
  
  
  RESULTS
  In total 258 GPs responded to the questionnaire. Although 219 (84.9%) responders reported awareness of the NICE guidance only 146 (56.6%) had personally read the document. The majority 187 (72.5%) of respondents anticipated that their use of CA125 would increase as a result of the new guidance. Abdominal bloating (>50 years), persistent abdominal distension and the presence of an abdominal or pelvic mass/swelling were the symptoms felt to be most associated with ovarian cancer. When questioned on the management of a woman with a raised CA125 the majority of respondents reported that a normal ultrasound scan would not stop an urgent secondary care referral if the CA125 was raised. There was no significant difference in the opinions of GPs with <5 years primary care experience compared to GPs with 6+ years.
  
  
  CONCLUSIONS
  The symptoms associated with ovarian cancer are well understood by the GPs that responded however, a coordinated programme of education and training is needed for GPs on the role of CA125 in ovarian cancer, in addition to clearly defined referral pathways, in order to address a likely significant increase in suspected ovarian cancer referrals to secondary care, most of whom will not have ovarian cancer.
authors: Esther L
authors: EL
authors: Moss
authors: Alison
authors: A
authors: Moran
authors: Timothy M
authors: TM
authors: Reynolds
authors: Helen
authors: H
authors: Stokes-Lampard
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D004739:England; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration*; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen