Assessment of symptomatic women for early diagnosis of ovarian cancer: results from the prospective DOvE pilot project

Gilbert, Lucy; Basso, Olga; Sampalis, John S.; Karp, Igor; Martins, Claudia; Jin, Feng; Piedimonte, Sabrina; Quintal, L; Ramanakumar, Agnihotram V.; Takefman, Janet; Grigorie, Maria S; Artho, Giovanni; Krishnamurthy, Srinivasan

doi:10.1016/s1470-2045(11)70333-3

Cited by 133 publications

(125 citation statements)

References 32 publications

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“…This suggests that in Type II iEOC a symptom‐based intervention is more likely to influence tumour volume than impact on stage. This is supported by the recent prospective study (DOvE study; Diagnosing Ovarian Cancer Early)38 where CA125 testing and transvaginal ultrasound in women with ovarian cancer symptoms resulted in detection of lower volume disease in women with high‐grade serous ovarian cancers 39. Diagnosis at lower tumour volumes is likely to improve the surgeon's ability to achieve zero residual disease at surgery, a key prognostic factor in disease survival 40.…”

Section: Discussionmentioning

confidence: 89%

Time to diagnosis of Type I or II invasive epithelial ovarian cancers: a multicentre observational study using patient questionnaire and primary care records

Lim

Mesher

Gentry‐Maharaj

et al. 2015

BJOG

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ObjectiveTo compare time to diagnosis of the typically slow‐growing Type I (low‐grade serous, low‐grade endometrioid, mucinous, clear cell) and the more aggressive Type II (high‐grade serous, high‐grade endometrioid, undifferentiated, carcinosarcoma) invasive epithelial ovarian cancer (iEOC).DesignMulticentre observational study.SettingTen UK gynaecological oncology centres.PopulationWomen diagnosed with primary EOC between 2006 and 2008.MethodsSymptom data were collected before diagnosis using patient questionnaire and primary‐care records. We estimated patient interval (first symptom to presentation) using questionnaire data and diagnostic interval (presentation to diagnosis) using primary‐care records. We considered the impact of first symptom, referral and stage on intervals for Type I and Type II iEOC.Main outcome measuresPatient and diagnostic intervals.ResultsIn all, 78% of 60 Type I and 21% of 134 Type II iEOC were early‐stage. Intervals were comparable and independent of stage [e.g. median patient interval for Type I: early‐stage 0.3 months (interquartile range 0.3–3.0) versus late‐stage 0.3 months (interquartile range 0.3–4.5), P = 0.8]. Twenty‐seven percent of women with Type I and Type II had diagnostic intervals of at least 9 months. First symptom (questionnaire) was also similar, except for the infrequent abnormal bleeding (Type I 15% versus Type II 4%, P = 0.01). More women with Type I disease (57% versus 41%, P = 0.04) had been referred for suspected gynaecological cancer. Median time from referral to diagnosis was 1.4 months for women with iEOC referred via a 2‐week cancer referral to any specialty compared with 2.6 months (interquartile range 2.0–3.7) for women who were referred routinely to gynaecology.ConclusionOverall, shorter diagnostic delays were seen when a cancer was suspected, even if the primary tumour site was not recognised to be ovarian. Despite differences in carcinogenesis and stage for Type I and Type II iEOC, time to diagnosis and symptoms were similar. Referral patterns were different, implying subtle symptom differences. If symptom‐based interventions are to impact on ovarian cancer survival, it is likely to be through reduced volume rather than stage‐shift. Further research on histological subtypes is needed.Tweetable abstractNo difference in time to diagnosis for Type I versus Type II invasive epithelial ovarian cancers.

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Section: Discussionmentioning

confidence: 89%

Time to diagnosis of Type I or II invasive epithelial ovarian cancers: a multicentre observational study using patient questionnaire and primary care records

Lim

Mesher

Gentry‐Maharaj

et al. 2015

BJOG

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show abstract

“…Nevertheless, early diagnosis could still improve outcomes for ovarian cancer. For example, the majority of high-grade serous ovarian cancers (HGSCs) (which are included in type II epithelial ovarian cancers; responsible for the majority of all ovarian cancer mortality (Brown and Palmer, 2009)) originate outside the ovaries, spreading to the ovaries as they progress (Gilbert et al, 2012). This results in these tumours becoming advanced-stage early in their development (Cho and Shih, 2009).…”

mentioning

confidence: 99%

Experience of Symptoms Indicative of Gynaecological Cancers in UK Women

Low¹,

Simon²,

Waller³

et al. 2013

Obstetrical &Amp; Gynecological Survey

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Background: Gynaecological cancers account for B12% of female cancer incidence in the United Kingdom. Encouraging prompt help-seeking for potential symptoms could help improve outcomes. However, before developing help-seeking interventions, it is important to estimate the number of women with symptoms potentially indicative of a gynaecological cancer to help estimate the impact of such interventions on primary care.

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“…The late-stage cases that were detected had smaller, more resectable tumour volumes, with a larger pro- portion showing disease localized to the fallopian tube instead of having ovary involvement. 21 Findings from this study emphasize the need to detect disease at more resectable, lower volumes. 21 A 2010 publication showed that advanced cases of serous carcinoma (type 2) had a shorter duration of symptoms compared with mucinous carcinoma (type 1).…”

Section: Discussionmentioning

confidence: 71%

“…21 Findings from this study emphasize the need to detect disease at more resectable, lower volumes. 21 A 2010 publication showed that advanced cases of serous carcinoma (type 2) had a shorter duration of symptoms compared with mucinous carcinoma (type 1). 22 This suggests that the late-stage diagnosis of serous carcinoma cases is likely due to rapid progression rather than delay in detection.…”

Section: Discussionmentioning

confidence: 71%

Diagnostic and referral intervals for Manitoba women with epithelial ovarian cancer - the Manitoba Ovarian Cancer Outcomes (MOCO) study group: a retrospective cross-sectional study

et al. 2017

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Assessment of symptomatic women for early diagnosis of ovarian cancer: results from the prospective DOvE pilot project

Cited by 133 publications

References 32 publications

Time to diagnosis of Type I or II invasive epithelial ovarian cancers: a multicentre observational study using patient questionnaire and primary care records

Time to diagnosis of Type I or II invasive epithelial ovarian cancers: a multicentre observational study using patient questionnaire and primary care records

Experience of Symptoms Indicative of Gynaecological Cancers in UK Women

Diagnostic and referral intervals for Manitoba women with epithelial ovarian cancer - the Manitoba Ovarian Cancer Outcomes (MOCO) study group: a retrospective cross-sectional study

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