Temporal patterns of conditions and symptoms potentially associated with ovarian cancer.
BACKGROUND
The late stage at which ovarian cancer is typically diagnosed and its subsequent high mortality have been attributed to a lack of symptoms in its early stages. This study examined the temporal patterns of prediagnostic ovarian cancer symptoms and conditions among women with and without ovarian cancer.


METHODS
We identified 920 ovarian cancer cases from 1998-2002 claims and encounters from Thomson Healthcare's Medstat MarketScan Commercial Claims and Encounters and Medicare Supplemental Databases. These were matched with 2760 comparison women based on age, geographic region, Medicare eligibility, and health plan type. The rates of ovarian cancer-related symptoms, conditions, and procedures recorded in the claims data were compared between the two groups using chi-square and Student's t tests.


RESULTS
In the 270 to 31 days prior to the case diagnosis dates, cases had nearly five times more recorded abdominal symptoms (36.2% vs. 7.5%), 3.5 times more recorded female genital symptoms (9.8% vs. 2.7%), and 1.5-2 times more recorded gastrointestinal symptoms (7.7% vs. 3.5%), urethra/urinary tract disorders (12.7% vs. 6.4%), and menopausal disorders (12.4% vs. 7.5%) than the comparison women. However, when the data were examined in 30-day increments for these five diagnosed conditions, the rates for cases and comparison women only started to diverge as the cases' diagnosis drew closer-60-90 days prior.


CONCLUSIONS
The presence of ovarian cancer-related symptoms and conditions prior to diagnosis among cases was documented in claims data; however, this increase was most pronounced in the 2-3 months prior to diagnosis. It is likely that physicians will see similar symptoms and conditions for women with and without ovarian cancer during most of the 9 months prior to the cases' diagnosis.
Wynn
Michelle L
ML
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Chang
Stella
S
Peipins
Lucy A
LA
D015746:Abdominal Pain / Q000175:diagnosis / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D015984:Causality; D015897:Comorbidity; D042241:Early Diagnosis; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008487:Medical History Taking / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D017699:Pelvic Pain / Q000175:diagnosis / Q000453:epidemiology; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data*; D014555:Urination Disorders / Q000175:diagnosis / Q000453:epidemiology; D016387:Women's Health