Comparison of symptoms and presentation of women with benign, low malignant potential and invasive ovarian tumors

Objectives: To describe symptoms, delay in presentation and reasons for non-presentation among women diagnosed with benign, low malignant potential and malignant ovarian tumors. Methods: Study participants included 457 women who underwent surgery for an ovarian tumor in Queensland, Australia, between July 1999 and February 2002 (244 with invasive cancer, 62 with low malignant potential tumors, and 151 with benign ovarian tumors). Women were contacted a minimum of three months post-diagnosis. Information concerning symptoms and presentation history was obtained via interview. Results: Overall, only 8% of the women were asymptomatic at the time of their diagnosis. Women with invasive cancer reported a greater number of symptoms (3.1 and 3.6 for Stages T-II and III-IV, respectively) than women with benign or low malignant potential tumors (2.8 and 2.2 respectively; p <0.0001). Women with invasive disease were more likely to experience weight loss or gain, general malaise, chest/respiratory pain, abdominal swelling and bowel symptoms than women with benign ovarian tumors, however the symptom pattern for early- and late-stage invasive ovarian cancer could not be clearly differentiated. There was no suggestion that women with advanced stage disease had delayed longer before presenting to their doctor. The most common reasons given for not telling their doctor about specific symptoms were the woman's perception that the symptom was not serious enough, it was mild or intermittent, or was related to normal physical changes associated with age or menopause. Conclusions: We found only marginal differences in the symptom patterns of early and advanced stage invasive cancer. Delay in presentation was not associated with more advanced disease suggesting that earlier diagnosis may not increase the proportion of cancers diagnosed at an early stage.