A new study published in JAMA Network Open by researchers from the University of North Carolina at Chapel Hill on Mar. 27 examines how the timing of diagnosis affects survival rates for ovarian cancer patients.
Ovarian cancer is difficult to detect early because its symptoms, such as bloating and abdominal pain, are often vague and similar to those of other common conditions. Early diagnosis generally improves outcomes for many cancers, but previous research has suggested that faster diagnosis does not necessarily lead to better survival rates in ovarian cancer. This has led some experts to question investments in improved diagnostic tools.
The study, led by Sarah Soppe, MPH, a doctoral candidate at the UNC Gillings School of Global Public Health, analyzed data from over 2,300 women with ovarian cancer in North Carolina. The team examined patient characteristics and the time between initial symptom-related clinic visits and eventual diagnosis. Using advanced statistical methods, they found a U-shaped relationship: both very short and very long diagnostic intervals were linked with worse survival compared to intervals that fell in the middle range.
"This could be masking the benefits of early diagnosis and explain why faster diagnosis doesn't always appear to improve survival," said Soppe. She explained that sicker patients tend to be diagnosed more quickly but also have poorer prognoses—a phenomenon known as the "wait time paradox." The study suggests that considering how ill patients appeared at their first visit may help address this issue.
Caroline A. Thompson, PhD, senior author and associate professor of epidemiology at UNC Gillings School as well as research fellow for the UNC Center for Health Promotion and Disease Prevention (HPDP), said: "The takeaway is that diagnostic delays may actually matter for ovarian cancer. Our hope is that these findings will encourage more research and investment into tools that improve diagnostic timing and outcomes for this aggressive cancer."
The research was supported by grants from the UNC CDC Health Promotion and Disease Prevention Research Center along with funding from Ovarian Cancer Research Alliance.
