Ovarian carcinoma diagnosis - Results of a National Ovarian Cancer Survey

BAGKGROUND, Ovarian carcinoma often is called the "silent killer" because t he disease usually is not detected until an advanced stage. The authors' go al was to evaluate preoperative symptoms and factors that may contribute to delayed diagnosis for women with ovarian carcinoma. METHODS. A two-page survey was distributed to 1500 women who subscribe to C ONVERSATIONS!, a newsletter about ovarian carcinoma. Because the survey cou ld be copied and given to other patients, 1725 surveys were returned from w omen in 46 states and 4 Canadian provinces. RESULTS. The median age of the surveyed women was 52 years, and 70% had Sta ge III or IV disease (International Federation of Gynecology and Obstetrics ). When asked about symptoms before the diagnosis of ovarian carcinoma, 95% reported symptoms, which were categorized as abdominal (77%), gastrointest inal (70%), pain (58%), constitutional (50%), urinary (34%), and pelvic (26 %). Only 11% of women with Stage I/II and 3% with Stage III/IV reported no symptoms before their diagnosis. Women who ignored their symptoms were sign ificantly more likely to be diagnosed with advanced disease compared with t hose who did not (P = 0.002). The time required for a health care provider to make the diagnosis was reported as less than 3 months by 55%, but greate r than 6 months by 26% and greater than 1 year by 11%. Factors significantl y associated with delay in diagnosis were omission of a pelvic exam at firs t visit; having a multitude of symptoms; being diagnosed initially with no problem, depression, stress, irritable bowel, or gastritis; not initially r eceiving an ultrasound, computed tomography, or CA. 125 test; and younger a ge. The type of health care provider seen initially, insurance, and specifi c symptoms did not correlate with delayed diagnosis. CONCLUSIONS. This large national survey confirms that the majority of women with ovarian carcinoma are symptomatic and frequently have delays in diagn osis. (C) 2000 American Cancer Society.