title: Types and duration of symptoms prior to diagnosis of invasive or borderline ovarian tumor.
abstract: OBJECTIVE
  The objective was to describe and compare types and duration of symptoms among women with invasive versus borderline ovarian tumors.
  
  
  METHODS
  Cases were women, ages 20-69 years, diagnosed with invasive (616) and borderline (151) epithelial ovarian tumors from 1994 to 1998. Symptoms were obtained using a standardized in-person interview. Differences in types and duration of symptoms, time to diagnosis after consulting a physician, and primary reason for diagnosis by invasive/borderline status and histologic type were determined using bivariate and regression analyses controlling for age.
  
  
  RESULTS
  Borderline and invasive cases reported similar types of symptoms. However, borderline cases were twice as likely to report not having had symptoms as invasive cases (16 vs 8%, P = 0.005). Prediagnostic symptom duration was longer among borderline versus invasive cases (median: 6 vs 4 months, P < 0.001). The median time from first consultation with a physician to diagnosis (1 month) did not differ by invasive/borderline status. Borderline cases were twice as likely to be diagnosed through routine examination as invasive cases (28 vs 16%, P = 0.001). Invasive cases were more likely to be diagnosed because of symptoms (62 vs 48%, P = 0.002).
  
  
  CONCLUSIONS
  Because most (90%) women with ovarian tumors have symptoms and median symptom duration is 4 months, greater awareness of symptoms by women and physicians is needed for the earlier detection of ovarian tumors. The lesser likelihood of being detected by routine examination and the shorter symptom duration for invasive versus borderline cases underscores the need for effective screening and preventive strategies.
authors.affiliation: Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. vine0002@mc.duke.edu
authors.forename: M F
authors.initials: MF
authors.lastname: Vine
authors.forename: R B
authors.initials: RB
authors.lastname: Ness
authors.forename: B
authors.initials: B
authors.lastname: Calingaert
authors.forename: J M
authors.initials: JM
authors.lastname: Schildkraut
authors.forename: A
authors.initials: A
authors.lastname: Berchuck
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology*; D012959:Socioeconomic Factors