Predictive values of gynaecological cancer alarm symptoms in a general population

Aim: The aim of this study was to determine predictive values of gynaecological alarm symptoms in the general population. Materials and Methods: A population-based prospective cohort study combining questionnaire data with register data of gynaecological cancer and premalignant conditions in a one-year follow-up period. Results: Among 25,866 women, some 2,957 (11.4%) reported at least one newly onset gynaecological cancer alarm symptom within a four-week time period. A total of 71 women were diagnosed with a gynaecological cancer or a premalignant condition. The positive predictive values (PPVs) ranged between 0.1% (95%-CI: 0.1-0.1) for cancer among women reporting at least one of the 18 unspecific and specific gynaecological cancer alarm symptoms and 0.3% (95%-CI: 0.2-0.4) for dysplasia among women reporting at least one of the specific alarm symptoms that lead to a GP contact. The positive likelihood ratios (LR+s) ranged between 0.9 (95%-CI: 0.7;1.2) for cancer among women reporting at least one unspecific symptom and 1.7 (95%-CI: 1.1-2.5) for dysplasia among women reporting at least one specific alarm symptom. Conclusion: The PPVs and LR+s of gynaecological alarm symptoms. Thus targeted diagnosis of gynaecological cancer cannot be based on cancer alarm symptoms only.