title: Diagnostic delay, quality of life and patient satisfaction among women diagnosed with endometrial or ovarian cancer: a nationwide Danish study.
abstract: BACKGROUND
  This study investigates the association between diagnostic delay (total delay), quality of life (QoL) and patient satisfaction, and the associations between QoL and patient satisfaction scores and survival for women diagnosed with ovarian or endometrial cancer.
  
  
  METHODS
  A questionnaire survey was conducted among 723 women diagnosed with ovarian or endometrial cancer from 2006 to 2007; 453 women were chosen to participate in the study. Data on total delay (number of weeks between first cancer symptom and initiation of treatment) were available from 353 women.
  
  
  RESULTS
  Experiencing longer total delay was associated with reduced overall QoL and appetite loss among ovarian cancer patients, while longer total delay was associated with reduced overall QoL, reduced role and social functioning, and increased fatigue, insomnia and constipation among endometrial cancer patients. Likewise, longer total delay was associated with decreased patient satisfaction for both cancer types. For survival and QoL scores, worse scores for pain were statistically significantly associated with reduced survival for women diagnosed with ovarian cancer, while reduced overall QoL, physical, role and emotional functioning as well as increased nausea and vomiting, pain, dyspnoea and appetite loss were associated with reduced survival for women diagnosed with endometrial cancer. For survival and patient satisfaction, associations were not significant when adjusted for diagnosis, age, cancer stage and radicality of operation.
  
  
  CONCLUSIONS
  We found that few QoL measures were associated with total delay and survival for ovarian cancer, while a number of associations were found between QoL, total delay and survival for endometrial cancer patients. This supports the hypothesis that long total delay may influence QoL and survival for some cancer patients. Reduced patient satisfaction with the diagnostic phase was also statistically significantly associated with long total delay, highlighting that total delay is an important component in patients' evaluation of the care they receive.
authors.affiliation: Department of Health Services Research, Institute of Public Health, Copenhagen University, Oester Farimagsgade 5B, 1014, Copenhagen K, Denmark. Kirm@sund.ku.dk
authors.forename: Kirstine M
authors.initials: KM
authors.lastname: Robinson
authors.forename: Karl Bang
authors.initials: KB
authors.lastname: Christensen
authors.forename: Bent
authors.initials: B
authors.lastname: Ottesen
authors.forename: Allan
authors.initials: A
authors.lastname: Krasnik
mesh_terms: D000368:Aged; D016001:Confidence Intervals; D016208:Databases, Factual; D057210:Delayed Diagnosis / Q000523:psychology*; D003718:Denmark; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006176:Gynecology; D019538:Health Care Surveys; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D017060:Patient Satisfaction; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D016387:Women's Health