UICC World Cancer Congress 2006

The purpose of this presentation is to describe the prevalence and clinical characteristics of symptoms at the time of seeking initial care for primary invasive ovarian cancer; the number of medical visits before diagnosis; type of provider(s) and number before diagnosis; number and type of diagnostic procedures before final diagnosis; patients' experience with providers; and patient's sociodemographic characteristics. Patients were selected from several major medical institutions in Harris County, Texas including the University Of Texas M. D. Anderson Cancer Center (UTMDACC), Harris County Hospital District's Lyndon B. Johnson Hospital (LBJ), St. Luke's Hospital, and Hermann Hospital. These institutions constitute the outreach program of the UTMDACC Department of Gynecologic Oncology. Women 18 years old or older diagnosed between December, 2002 and August, 2004, English or Spanish speakers were eligible to participate. A face-to-face computer-assisted interview was developed based on information obtained in the literature review using QDS®. A total of 139 women diagnosed with primary ovarian cancer were recruited. Over 70% of patients (72%) were recruited at UTMDACC, and the rest at LBJ, ST. Luke's, and Memorial Hermann Hospitals. The majority (70%) were white (n=98), 15% Hispanics (n=21), 13% African-American (n=18), 1% other (n=2). Median Age of at diagnosis was 55 years old (ranged 22-84). The majority were married or living in a married-liked situation (54%), and had some college or college degree (65%). Eighty-seven percent of patients (n=121) reported some type of symptom prior to diagnosis. The most commonly reported symptoms were abdominal bloating/swelling (78%), lower abdominal pressure (58%), abdominal pain (52%), painful gas (46%), back pain (46%), felling full after eating some bites (46%), indigestion (44%), urinary urgency (43%) and constipation (41%). Among symptomatic patients, the most noticeable reported symptoms included abdominal/pelvic pain (27%), abdominal bloating (21%), and abdominal swelling followed by back pain (7%) and constipation (5%). The most commonly reported provider seen by these patients were family physician/internal medicine (53%) and Obstetric and Gynecologist (26%). About 72% saw a provider in a private practice or HMO; whereas, 20% attended a public clinic or hospital. Approximately 50% of patients reported seen 2 or less provider before diagnosis, 26% saw 3, and 23% saw 4 or more. A pelvic examination during the first medical visit was reported by 51% of the participants; whereas, only 4 patients (3%) reported never having had a pelvic exam before diagnosis. Approximately 35% of patients reported feeling like there had been a delay in seeking health care. During the process of diagnosis 68% of the patients reported to have received a urinary analysis, 53%a CT-Scan, 50% a CA-125, 39% an ultrasound, 24% a barium enema, 19% a colonoscopy, 13% an Upper GI/endoscopy, and 6%rectosigmoidoscopy. Results from this population are consistent with previous reports.