Ovarian cancer symptom awareness and anticipated delayed presentation in a population sample

Abstract

BackgroundWhile ovarian cancer is recognised as having identifiable early symptoms, understanding of the key determinants of symptom awareness and early presentation is limited. A population-based survey of ovarian cancer awareness and anticipated delayed presentation with symptoms was conducted as part of the International Cancer Benchmarking Partnership (ICBP).MethodsWomen aged over 50 years were recruited using random probability sampling (n = 1043). Computer-assisted telephone interviews were used to administer measures including ovarian cancer symptom recognition, anticipated time to presentation with ovarian symptoms, health beliefs (perceived risk, perceived benefits/barriers to early presentation, confidence in symptom detection, ovarian cancer worry), and demographic variables. Logistic regression analysis was used to identify the contribution of independent variables to anticipated presentation (categorised as < 3 weeks or ≥ 3 weeks).ResultsThe most well-recognised symptoms of ovarian cancer were post-menopausal bleeding (87.4%), and persistent pelvic (79.0%) and abdominal (85.0%) pain. Symptoms associated with eating difficulties and changes in bladder/bowel habits were recognised by less than half the sample. Lower symptom awareness was significantly associated with older age (p ≤ 0.001), being single (p ≤ 0.001), lower education (p ≤ 0.01), and lack of personal experience of ovarian cancer (p ≤ 0.01). The odds of anticipating a delay in time to presentation of ≥ 3 weeks were significantly increased in women educated to degree level (OR = 2.64, 95% CI 1.61 – 4.33, p ≤ 0.001), women who reported more practical barriers (OR = 1.60, 95% CI 1.34 – 1.91, p ≤ 0.001) and more emotional barriers (OR = 1.21, 95% CI 1.06 – 1.40, p ≤ 0.01), and those less confident in symptom detection (OR = 0.56, 95% CI 0.42 – 0.73, p ≤ 0.001), but not in those who reported lower symptom awareness (OR = 0.99, 95% CI 0.91 – 1.07, p = 0.74).ConclusionsMany symptoms of ovarian cancer are not well-recognised by women in the general population. Evidence-based interventions are needed not only to improve public awareness but also to overcome the barriers to recognising and acting on ovarian symptoms, if delays in presentation are to be minimised.

Women's Knowledge on Ovarian Cancer Symptoms and Risk Factors in Nigeria: An Institutional-based Study

“…Majority of the women in our study had very poor knowledge of the symptoms and risk factors of ovarian cancer, even though their level of awareness of the disease was high. This is similar to the findings in several studies [2,6,14,20,25], which have consistently shown poor knowledge of the disease among women. In America, only 15% of the women reported they were either familiar or very familiar with the symptoms of ovarian cancer [20].…”

“…It is not surprising that women with tertiary level of education had significantly better knowledge as compared with their counterparts. This is similar to the findings in the United States and United Kingdom, where women with higher levels of education were more knowledgeable of the symptoms and risk factors of ovarian cancer [14,20]. Education is a known determinant of quality of life and health [27]; and educated women are probably more empowered to have a better understanding of health-related issues.…”

“…Recent studies have shown that a significant proportion of women with ovarian cancer present with symptoms in both early and late stages of the disease [7][8][9][10][11][12][13]. Unfortunately, because these symptoms are non-specific, they may be attributed to other causes either by the women themselves [14,15] or by the inexperienced physician [16]. These symptoms include abdominal bloating or swelling, pelvic or abdominal discomfort or pain; gastrointestinal symptoms such as loss of appetite, early satiety, nausea, constipation, urinary symptoms; and weight loss [2,7,8,10,[14][15][16][17].…”

Age-specific discrimination of blood plasma samples of healthy and ovarian cancer prone mice using laser-induced breakdown spectroscopy

“…Despite rich and diverse research efforts, early detection and diagnosis of epithelial ovarian cancer (EOC) remains a significant challenge [3,4]. In the United States, approximately 22,000 women are diagnosed with EOC each year.…”

Immunohistochemical Expression of Human Epididymis 4 (He4) in Ovarian Serous Carcinoma in Hospital Serdang from the Year 2006- 2013

“…This is the possible reason for the delayed seeking of medical attention. The early symptoms include abdominal distension (bloating, increased abdominal size), pelvic and/or abdominal pain, problems with eating (loss of appetite, feeling full quickly), and frequent urination [5]. Based on the study done by Brain, et al [5], the most well-identified symptoms of ovarian cancer were post-menopausal bleeding (87.4%), and persistent pelvic (79.0%) and abdominal (85.0%) pain.…”