{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:36:09Z","timestamp":1793104569847,"version":"4.5.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To evaluate the potential harms and ovarian cancer outcomes associated with symptom-triggered diagnostic evaluation of all women with symptoms of ovarian cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Five thousand twelve women older than age 40 years were prospectively enrolled in a cohort study of proactive symptom-triggered diagnostic evaluation. Women who tested positive on a symptom index were offered testing with CA 125 and transvaginal ultrasonography. Results of these tests and any subsequent procedures were recorded. Assessment of ovarian cancer outcomes for all participants through Surveillance, Epidemiology, and End Results was performed 1 year after enrollment was complete.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>A positive symptom index was found in 241 (4.8%) participating patients, and 211 (88%) underwent CA 125 testing, transvaginal ultrasound screening, or both. Twenty surgical procedures (laparoscopy, laparotomy, vaginal) were performed in the study population (0.4% of participating women). However, only six (0.12%) were performed for a suspicious ovarian mass and only four (0.08%) were performed solely as a result of study participation. A total of eight ovarian cancers were diagnosed, 31\u2013843 days after symptom assessment (50% distant, 50% local or regional). Of the two cancers diagnosed within 6 months, one was symptom index\u2013positive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Proactive symptom-triggered diagnostic evaluation for ovarian cancer results in minimal unindicated surgery. A small number of ovarian cancers was identified solely on the basis of symptom-triggered diagnostic testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LEVEL OF EVIDENCE:<\/jats:title>\n                    <jats:p>II<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/aog.0000000000000051","type":"journal-article","created":{"date-parts":[[2013,12,9]],"date-time":"2013-12-09T04:18:57Z","timestamp":1386562737000},"page":"73-79","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Value of Symptom-Triggered Diagnostic Evaluation for Ovarian Cancer"],"prefix":"10.1097","volume":"123","author":[{"given":"M. Robyn","family":"Andersen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A.","family":"Lowe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A.","family":"Goff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-12-20261027","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1097\/AOG.0b013e31821477db","article-title":"Committee Opinion No. 477. 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American College of Obstetricians and Gynecologists.","volume":"113","year":"2009","journal-title":"Obstet Gynecol"},{"key":"R12-12-20261027","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1001\/jama.2011.766","article-title":"Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening randomized controlled trial","volume":"305","author":"Buys","year":"2011","journal-title":"JAMA"},{"key":"R13-12-20261027","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/S1470-2045(09)70026-9","article-title":"Sensitivity and specificity of multimodal and ultrasound screening for ovarian cancer, and stage distribution of detected cancers: results of the prevalence screen of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)","volume":"10","author":"Menon","year":"2009","journal-title":"Lancet Oncol"},{"key":"R14-12-20261027","doi-asserted-by":"crossref","first-page":"b2998","DOI":"10.1136\/bmj.b2998","article-title":"Risk of ovarian cancer in women with symptoms in primary care: population based case-control study","volume":"339","author":"Hamilton","year":"2009","journal-title":"BMJ"},{"key":"R15-12-20261027","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1002\/cncr.21310","article-title":"Ovarian cancer: can we make the clinical diagnosis earlier?","volume":"104","author":"Smith","year":"2005","journal-title":"Cancer"},{"key":"R16-12-20261027","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1093\/fampra\/cmi044","article-title":"Early symptoms of ovarian cancer: a case-control study without recall bias","volume":"22","author":"Freidman","year":"2005","journal-title":"Fam Pract"},{"key":"R17-12-20261027","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1093\/jnci\/djp500","article-title":"Predictive value of symptoms for early detection of ovarian cancer","volume":"102","author":"Rossing","year":"2010","journal-title":"J Natl Cancer Inst"},{"key":"R18-12-20261027","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/S1470-2045(11)70333-3","article-title":"Assessment of symptomatic women for early diagnosis of ovarian cancer: results from the prospective DOvE pilot project","volume":"13","author":"Gilbert","year":"2012","journal-title":"Lancet Oncol"}],"container-title":["Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00006250-201401000-00012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:01:25Z","timestamp":1793102485000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00006250-201401000-00012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014]]}},"URL":"https:\/\/doi.org\/10.1097\/aog.0000000000000051","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.718277636.793490939","asserted-by":"object"}]},"ISSN":["0029-7844","1873-233X"],"issn-type":[{"value":"0029-7844","type":"print"},{"value":"1873-233X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,1]]}}}