Symptoms Relevant to Surveillance for Ovarian Cancer.
To examine how frequently and confidently healthy women report symptoms during surveillance for ovarian cancer. A symptoms questionnaire was administered to 24,526 women over multiple visits accounting for 70,734 reports. A query of reported confidence was included as a confidence score (CS). Chi square, McNemars test, ANOVA and multivariate analyses were performed. 17,623 women completed the symptoms questionnaire more than one time and >9500 women completed it more than one four times for >43,000 serially completed questionnaires. Reporting ovarian cancer symptoms was ~245 higher than ovarian cancer incidence. The positive predictive value (0.073%) for identifying ovarian cancer based on symptoms alone would predict one malignancy for 1368 cases taken to surgery due to reported symptoms. Confidence on the first questionnaire (83.3%) decreased to 74% when more than five questionnaires were completed. Age-related decreases in confidence were significant (p < 0.0001). Women reporting at least one symptom expressed more confidence (41,984/52,379 = 80.2%) than women reporting no symptoms (11,882/18,355 = 64.7%), p < 0.0001. Confidence was unrelated to history of hormone replacement therapy or abnormal ultrasound findings (p = 0.30 and 0.89). The frequency of symptoms relevant to ovarian cancer was much higher than the occurrence of ovarian cancer. Approximately 80.1% of women expressed confidence in what they reported.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. robert.ore@uky.edu.
Robert M
RM
Ore
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. labald1@uky.edu.
Lauren
L
Baldwin
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. dylan.woolum@uky.edu.
Dylan
D
Woolum
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. erikatay28@gmail.com.
Erika
E
Elliott
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. christiaan.d.wijers@vanderbilt.edu.
Christiaan
C
Wijers
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. chieh-yu.chen@uky.edu.
Chieh-Yu
CY
Chen
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. raware00@email.uky.edu.
Rachel W
RW
Miller
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. cpdesi00@uky.edu.
Christopher P
CP
DeSimone
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. fuela0@email.uky.edu.
Frederick R
FR
Ueland
Department of Statistics, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. jrvann2@email.uky.edu.
Richard J
RJ
Kryscio
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. richard.kryscio@uky.edu.
John R van
JR
Nagell
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Chandler Medical Center-Markey Cancer Center, Lexington, KY 40536-0293, USA. epaul1@uky.edu.
Edward J
EJ
Pavlik
certainty/uncertainty; questionnaire; symptoms