open access: No difference in time to diagnosis for Type I vs Type II invasive epithelial ovarian cancers

open access

Objective

To 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).

First symptom

The first symptom reported was similar for Type I and II cancers with the exception of more irregular vaginal bleeding (almost all postmenopausal) in Type I (Q: 15% versus 4%, P = 0.01) (see Table 2). Abdominal symptoms were the most common (Q: Type I 77% and Type II 65%), whereas gynaecological symptoms were the least common (Q: Type I 15% and Type II 4%). The reporting of bloating and increased abdominal size was three to four times higher on questionnaire than in primary-care records (e.g. Type II bloating 40% Q versus 9% GP)......

...If time to diagnosis was a significant contributor to stage at diagnosis, then patient and diagnostic intervals should be different between the biologically disparate Type I and Type II iEOC. Instead it seems that the link between symptoms and tumour biology in ovarian cancer is complex and that a symptom-based intervention may not result in earlier stage diagnosis of Type II iEOC.