THE INTERNIST AND OVARIAN-CANCER

For the purpose of evaluating the role and participation of the intern ist in the diagnosis of Epithelial Ovarian Cancer (EOC), 81 medical re cords belonging to patients with EOC, were analyzed. The mean age of t he patients was 63.5 years old (SD 12.33). Of these patients 21% were asked about their personal and familiar oncology history during their first office visit. Thirteen patients (16%) were asymptomatic in the f irst consultation. The more frequent symptoms were pain and abdominal distention. During this first examination, 46 patients (56.8%) present ed some evident physical sign, and EOC was suspected in 35 patients (P = 0.00000004): the most frequent sign was an abdominopelvic mass in 3 4 patients (74%), Forty-six patients with EOC (56.8%) consulted an int ernist and twenty-four patients (29.6%) a gynecologist at first evalua tion, without significant differences in diagnostic suspicion. Interni sts did not perform an abdomino-pelvic palpation. Gynecologists perfor med the abdomino-pelvic palpation in 74 patients, and 58 (78.4%) were found to be abnormal. The mean age of patients examined by internists was 68.2 years old, that is ten years older than the patients examined by gynecologists (P = 0.0007) and 70% were in Stages III and IV (P = 0.02). Gynecologists examined 9 asymptomatic patients (P = 0.0003) and 42% in Stages III and IV. The more frequent reasons for consultation to internists were abdominal pain (23 patients) and distention (17 pat ients). On the other hand metrorrhagia (9 patients) was the most commo n reason to consult a gynecologist. In conclusion, internists were fre quent receptors of women with ovarian cancer at the first consultation . Their patients were older and with a more advanced disease stage. Th e interrogation concerning the oncology history was insufficient and t he gastrointestinal symptoms were the most frequent cause for consulti ng an internist. The presence of some physical signs was associated wi th more diagnostic suspicion. The gynecologists examined more asymptom atic patients.