Less than half of women are diagnosed with ovarian cancer within a month of seeing a doctor, finds surveyBMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4419 (Published 18 October 2018) Cite this as: BMJ 2018;363:k4419
Less than half of women with symptoms that are common in ovarian cancer are diagnosed within one month of first seeing a doctor, a large global survey of women with the disease1 has found. Results also revealed low levels of awareness of the cancer among women and delays in seeking medical help.
“This study, for the first time, provides powerful evidence of the challenges faced by women diagnosed with ovarian cancer across the world, and sets an agenda for global change,” said Anwen Jones, chief executive officer of Target Ovarian Cancer in the UK and co-chair of the study, which was funded by the World Ovarian Cancer Coalition.
“We were especially shocked by the widespread lack of awareness of ovarian cancer,” she said. “It is vital that steps are taken to raise awareness of the disease and speed up diagnosis so that we can transform the outlook for the increasing numbers of affected women and their families.”
The survey included 1531 women from 44 countries, including more than 100 from the UK, who had been diagnosed with the cancer since January 2013.
More than 90% of survey participants had experienced multiple symptoms before being diagnosed. On average, the women experienced four or more symptoms with the commonest being increased abdominal size (53.6% of women), persistent bloating (48.4%), pain in the abdomen (44.9%), extreme fatigue (37.0%), and urinary frequency (36.5%).
Despite this, only 78.3% saw a health professional about them. And one in four waited three months or more before visiting a doctor with their symptoms, with 10% waiting longer than six months.
Just under half (43.2%) were diagnosed with ovarian cancer within one month of first visiting a doctor with symptoms. But this varied between countries, from 30% in the UK to 62.3% in Italy. One in 10 women took longer than a year to be diagnosed.
Women who had a high level of knowledge about ovarian cancer were more likely to be diagnosed within one month, with 58.3% being diagnosed in this time period. But the survey found that more than two thirds of the women taking part had never heard of ovarian cancer or knew anything about it before they were diagnosed. Just under 14% had known that increased abdominal size or persistent bloating were the commonest symptoms of the disease.
The coalition recommended raising awareness of ovarian cancer and common symptoms among women so that they seek medical help earlier. They also recommended improving education for GPs, emergency doctors, and gynaecologists on the key symptoms so they can refer appropriate patients for diagnostic tests and specialist assessment more quickly.
Commenting on what might improve earlier diagnosis, Iain McNeish, director of the Ovarian Cancer Research Centre, said, “The dream is a screening programme that works, but I think we are many years from that. So it’s going to be about rapid access to diagnosis, which involves patient, public, and GP education.” He added, “One thing I’ve observed, having now worked in several cancer centres around the UK, is that for women going to the GP, the time that it then takes to be diagnosed can be painfully long.”