Reducing Time to Diagnosis Does Not Improve Outcomes for Women...

Reducing Time to Diagnosis Does Not Improve Outcomes for Women With Symptomatic Ovarian Cancer: A Report From the Australian Ovarian Cancer Study Group
Christina M. Nagle⇓, Jane E. Francis, Anne E. Nelson, Helen Zorbas, Karen Luxford, Anna de Fazio, Sian Fereday, David D. Bowtell, Ad??le C. Green and Penelope M. Webb
+ Author Affiliations

From the Queensland Institute of Medical Research, Brisbane, Queensland; National Breast and Ovarian Cancer Centre; and University of Sydney at Westmead Millennium Institute, Westmead Hospital, Sydney, New South Wales; and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; and University of Manchester, Manchester, United Kingdom.
Corresponding author: Christina M. Nagle, PhD, Cancer and Population Studies, Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Queensland 4029, Australia; e-mail: [email protected].
Abstract
Purpose To determine if time to diagnosis is associated with stage of disease at diagnosis or survival among women with symptomatic ovarian cancer.

Methods A representative sample of Australian women (n = 1,463) with ovarian cancer diagnosed between 2002 and 2005 who participated in a population-based case-control study were interviewed regarding the events leading to their diagnosis and were observed for mortality for 5 years.

Results Of the 1,318 women (90%) who presented to a medical practitioner with symptoms, 55% presented within 1 month, 70% in less than 2 months, and 92% within 6 months of symptom onset. There were no significant differences in the time from symptom onset to first medical practitioner consultation (P = .19) or symptom onset to diagnosis (P = .64) among women with borderline, early (International Federation of Gynecology and Obstetrics [FIGO] stages I to II) or late (FIGO stages III to IV) disease. There was also no association between time to diagnosis and survival; adjusted hazard ratio for long delay (> 12 months from symptom onset to diagnosis) versus short delay (?? 1 month) was 0.94 (95% CI, 0.68 to 1.30). Women who had asymptomatic cancers diagnosed incidentally (n = 145) were younger and were more likely to have borderline or stage I disease compared with women who had symptomatic ovarian cancer.

Conclusion The results of this study suggest that, once ovarian cancer is symptomatic, reducing the time to diagnosis would not greatly alter stage of disease at diagnosis or survival.

http://jco.ascopubs.org/content/early/2011/04/26/JCO.2010.32.2164