title: Symptom presentation in invasive ovarian carcinoma by tumor histological type and grade in a multiethnic population: a case analysis.
abstract: OBJECTIVE
  Although the majority of women with ovarian carcinoma report symptoms prior to diagnosis, little is known about comparative symptom presentation by histological type, stage, grade, or ethnicity.
  
  
  METHODS
  We conducted a population-based study including 622 women with invasive ovarian carcinoma diagnosed from 1993 to 2008. Epidemiological and symptom data were collected using an interviewer-administered questionnaire. Symptoms established as significant predictors of ovarian carcinoma were examined in relation to patient and tumor characteristics, using unconditional multivariate logistic regression and general linear models.
  
  
  RESULTS
  Symptom presentation and duration differed significantly among women with ovarian carcinoma by stage, tumor histology, and grade, but not ethnicity. Significant differences were observed by histology in reporting a distended abdomen, abnormal vaginal bleeding, and bowel symptoms. Compared to women diagnosed with serous carcinoma, women with mucinous tumors were 2.6 times more likely to report a distended abdomen; women with endometrioid carcinoma were three times more likely to report abnormal bleeding. Women with serous tumors were significantly more likely to report bowel symptoms than were women diagnosed with other histological types. The majority of women with serous tumors were diagnosed with advanced cancer and had shorter duration of symptoms than women with early stage disease. In contrast, women with mucinous tumors were generally diagnosed at an early stage and had longer duration of symptoms (p=0.009) if diagnosed at an advanced stage.
  
  
  CONCLUSIONS
  The study provides evidence that the early diagnosis of ovarian cancer is largely determined by tumor histological type.
authors.affiliation: Cancer Epidemiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI 96813, USA. glurie@CRCH.hawaii.edu
authors.forename: Galina
authors.initials: G
authors.lastname: Lurie
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Thompson
authors.forename: Rayna K
authors.initials: RK
authors.lastname: Matsuno
authors.forename: Michael E
authors.initials: ME
authors.lastname: Carney
authors.forename: Marc T
authors.initials: MT
authors.lastname: Goodman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008593:Menopause / Q000378:metabolism; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology* / Q000473:pathology; D010298:Parity; D011247:Pregnancy; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal