. 2022 Sep;127(5):844-854.

doi: 10.1038/s41416-022-01844-0. Epub 2022 May 26.

Diagnostic routes and time intervals for ovarian cancer in nine international jurisdictions; findings from the International Cancer Benchmarking Partnership (ICBP)

Usha Menon¹, David Weller², Alina Zalounina Falborg³, Henry Jensen³, John Butler⁴, Andriana Barisic⁵, Anne Kari Knudsen^{6

7}, Rebecca J Bergin^{8

9}, David H Brewster^{2

10}, Victoria Cairnduff¹¹, Evangelia Ourania Fourkala¹², Anna T Gavin¹¹, Eva Grunfeld¹³, Elizabeth Harland¹⁴, Jatinderpal Kalsi¹², Rebecca-Jane Law¹⁵, Yulan Lin⁶, Donna Turner¹⁶, Richard D Neal¹⁷, Victoria White^{18

19}, Samantha Harrison²⁰, Irene Reguilon²⁰, Charlotte Lynch²⁰, Peter Vedsted²⁰; ICBP Module 4 Working Group

Collaborators, Affiliations

Collaborators

ICBP Module 4 Working Group:
Andriana Barisic, Anna Gavin, Breann Hawryluk, Chantelle Anandan, Conan Donnelly, Henry Jensen, Jackie Boylan, Jacqueline Kelly, Kerry Moore, Maria Rejmyr Davis, Martin Malmberg, Mats Lambe, Oliver Bucher, Peter Vedsted, Rebecca Bergin, Sigrun Saur Almberg, Therese Kearney, Tindie Kalsi, Victoria Hammersley

Affiliations

¹ MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, UK. u.menon@ucl.ac.uk.
² Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
³ Research Unit for General Practice, Aarhus, Denmark.
⁴ The Royal Marsden NHS Foundation Trust, London, UK.
⁵ Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada.
⁶ European Palliative Care Research Centre (PRC), Department of Oncology, Oslo, Norway.
⁷ University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁸ Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.
⁹ Department of General Practice, University of Melbourne, Melbourne, VIC, Australia.
¹⁰ Scottish Cancer Registry, Edinburgh, UK.
¹¹ Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK.
¹² Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK.
¹³ Health Services Research Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
¹⁴ Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Canada.
¹⁵ North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK.
¹⁶ Population Oncology, Cancer Care Manitoba, Winnipeg, Canada.
¹⁷ Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
¹⁸ School of Psychology Deakin University, Geelong, VIC, Australia.
¹⁹ Centre for Behavioral Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia.
²⁰ International Cancer Benchmarking Partnership, Cancer Research UK, Stratford, UK.

PMID: 35618787
PMCID: PMC9427750
DOI: 10.1038/s41416-022-01844-0

Diagnostic routes and time intervals for ovarian cancer in nine international jurisdictions; findings from the International Cancer Benchmarking Partnership (ICBP)

Usha Menon et al. Br J Cancer. 2022 Sep.

. 2022 Sep;127(5):844-854.

doi: 10.1038/s41416-022-01844-0. Epub 2022 May 26.

Authors

Collaborators

ICBP Module 4 Working Group:
Andriana Barisic, Anna Gavin, Breann Hawryluk, Chantelle Anandan, Conan Donnelly, Henry Jensen, Jackie Boylan, Jacqueline Kelly, Kerry Moore, Maria Rejmyr Davis, Martin Malmberg, Mats Lambe, Oliver Bucher, Peter Vedsted, Rebecca Bergin, Sigrun Saur Almberg, Therese Kearney, Tindie Kalsi, Victoria Hammersley

Affiliations

¹ MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, UK. u.menon@ucl.ac.uk.
² Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
³ Research Unit for General Practice, Aarhus, Denmark.
⁴ The Royal Marsden NHS Foundation Trust, London, UK.
⁵ Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada.
⁶ European Palliative Care Research Centre (PRC), Department of Oncology, Oslo, Norway.
⁷ University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁸ Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.
⁹ Department of General Practice, University of Melbourne, Melbourne, VIC, Australia.
¹⁰ Scottish Cancer Registry, Edinburgh, UK.
¹¹ Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK.
¹² Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK.
¹³ Health Services Research Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
¹⁴ Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Canada.
¹⁵ North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK.
¹⁶ Population Oncology, Cancer Care Manitoba, Winnipeg, Canada.
¹⁷ Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
¹⁸ School of Psychology Deakin University, Geelong, VIC, Australia.
¹⁹ Centre for Behavioral Research in Cancer, Cancer Council Victoria, Melbourne, VIC, Australia.
²⁰ International Cancer Benchmarking Partnership, Cancer Research UK, Stratford, UK.

PMID: 35618787
PMCID: PMC9427750
DOI: 10.1038/s41416-022-01844-0

Abstract

Background: International Cancer Benchmarking Partnership Module 4 reports the first international comparison of ovarian cancer (OC) diagnosis routes and intervals (symptom onset to treatment start), which may inform previously reported variations in survival and stage.

Methods: Data were collated from 1110 newly diagnosed OC patients aged >40 surveyed between 2013 and 2015 across five countries (51-272 per jurisdiction), their primary-care physicians (PCPs) and cancer treatment specialists, supplement by treatment records or clinical databases. Diagnosis routes and time interval differences using quantile regression with reference to Denmark (largest survey response) were calculated.

Results: There were no significant jurisdictional differences in the proportion diagnosed with symptoms on the Goff Symptom Index (53%; P = 0.179) or National Institute for Health and Care Excellence NG12 guidelines (62%; P = 0.946). Though the main diagnosis route consistently involved primary-care presentation (63-86%; P = 0.068), onward urgent referral rates varied significantly (29-79%; P < 0.001). In most jurisdictions, diagnostic intervals were generally shorter and other intervals, in particular, treatment longer compared to Denmark.

Conclusion: This study highlights key intervals in the diagnostic pathway where improvements could be made. It provides the opportunity to consider the systems and approaches across different jurisdictions that might allow for more timely ovarian cancer diagnosis and treatment.

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Conflict of interest statement

UM has a patent (no: EP10178345.4) for Breast Cancer Diagnostics and held a personal share of Abcodia between 1st April 2011 to 30 October 2021. Usha Menon is a member of the Research Advisory Panel, Yorkshire Cancer Research, Trial Steering Committee, NOVEL, and Scientific Advisory Board of Tina’s Wish. EOF has stocks in Johnson & Johnson.DHB is a member of the Board of Director of the Scottish Cancer Foundation. AB and EG received a honorarium for a lecture at the New Yok Obstetrics and Gynaecology. DT is an unpaid Board member of the International Association of Cancer Registries. Both the University of Leeds and RN will receive a share of future net royalties from the use of the Pinpoint test. RN also received an honorarium for a RCGP one-day essentials lecture. The remaining authors declare no competing interests.

Figures

**Fig. 1**
Time intervals measured as per the Aarhus Statement [13].

**Fig. 2**
Graphs of differing interval lengths across jurisdictions for the 50th (median), 75th and 90th percentiles across all nine jurisdictions (days).

See this image and copyright information in PMC

References

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1. Cabasag CJ, Butler J, Arnold M, Rutherford M, Bardot A, Ferlay J, et al. Exploring variations in ovarian cancer survival by age and stage (ICBP SurvMark-2): a population-based study. Gynecologic Oncol. 2020;157:234–44.. doi: 10.1016/j.ygyno.2019.12.047. - DOI - PubMed
1. Aust S, Seebacher-Shariat V. Screening for ovarian cancer: is there still hope? Magazine Eur Medical Oncol. 2020;13:189–92.
1. Jayde V, White K, Bloomfield P. Symptoms and diagnostic delay in ovarian cancer: a summary of the literature. Contemporary Nurse. 2014;34:55–65. - PubMed
1. Gajjar K, Ogden G, Mujahid MI, Razvi K. Symptoms and risk factors of ovarian cancer: a survey in primary care. ISRN Obstetrics Gynecol. 2012;2012:754197: 10.5402/2012/754197. - PMC - PubMed

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Diagnostic routes and time intervals for ovarian cancer in nine international jurisdictions; findings from the International Cancer Benchmarking Partnership (ICBP)

Collaborators

Affiliations

Diagnostic routes and time intervals for ovarian cancer in nine international jurisdictions; findings from the International Cancer Benchmarking Partnership (ICBP)

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical