Prompt diagnosis and treatment of ovarian cancer may not extend survival

Once symptoms of ovarian cancer appear, prompt diagnosis and treatment may not prolong survival, Australian researchers report. Most women with ovarian cancer die within 5 years of diagnosis.

Researchers at the Queensland Institute of Medical Research interviewed 1,463 Australian women who were diagnosed with ovarian cancer between 2002 and 2005 about the events leading to their diagnosis and then followed them for 5 years. Among women with invasive, symptomatic cancer, survival time wasn’t significantly influenced by how soon they saw their doctor after experiencing symptoms. Fifty-two percent of those who were diagnosed within 1 month of their first symptoms survived for 5 years compared with 53% of women who were diagnosed more than 1 year after symptoms appeared.

“The results of this study suggest that, once ovarian cancer is symptomatic, reducing the time to diagnosis would not greatly alter stage of disease at diagnosis or survival,” the authors conclude. “Indeed, women with poorer survival tended to report shorter times to diagnosis, suggesting that the presence of more aggressive disease may have accelerated their presentation and subsequent investigation,” they write.

The study was published online May 2 in the Journal of Clinical Oncology.

Most of the women in the study had symptoms before they were diagnosed; the rest were diagnosed during a routine check-up or surgery for another condition. Thirty-nine percent of women with symptoms saw their doctor and were diagnosed within 2 months of the onset of symptoms; about 61% were diagnosed within 3 months; and 80% were diagnosed within 6 months.

Women diagnosed while still asymptomatic lived longer than symptomatic women. Those with late-stage cancer and no symptoms survived an average of 4 years after diagnosis compared with 3 years for symptomatic women, and women with asymptomatic cancers that were diagnosed incidentally were younger than women with symptomatic cancer and were more likely to have borderline or stage I disease.

The study’s findings “do not mean that women who have persistent symptoms that might be due to ovarian cancer should not seek immediate medical attention,” notes lead author Christina Nagle. “Presenting promptly will help ensure that they are appropriately referred and can then make informed choices about their treatment.”