Denise Manon Langabeer, MBA, Ph.D. of MD Anderson gives an overview from ASCO 2020 the abstract entitled Are symptoms distinguishable in ovarian cancer? A nested case-control study of insurance claims.
Step III and IV disease was diagnosed in over 60 percent of ovarian cancer cases. A common screening procedure for ovarian cancer is not funded by the US healthcare system. Our aim was to decide if some signs are distinguishable between women diagnosed with ovarian cancer and women without ovarian cancer, based on ICD-9 categories.
In order to endorse a nested case-control study of health insurance claims from a commercial payer between 2008 and 2013, women diagnosed with ovarian cancer were randomly compared 1:1 to women without cancer. The following eligibility requirements were applied: (1) 24 years of age or older; (2) consistently enrolled for a minimum of 6 months in the health care plan; (3) witnessed more than 1 symptom during the monitoring period; and (4) observed for a minimum of 6 months. Symptoms were based on 47 ICD-9 diagnostic codes and classified for discomfort, abdominal, pelvic, intestinal, and bladder specific. 1,578 women (789 cases; 789 controls) were the source of the study.
Overall, 90% (n=1,421) of women had abdominal and pelvic symptoms and 92% (n=725) of women with ovarian cancer consulted their doctor 6-70 months prior to diagnosis for this complaint, OR 1.66 (CI 1.14 to 2.41; p=.008). In cases with approximately 60 percent (n = 464) and controls with 48 percent (n = 376); OR 1.75 (CI 1.39 to 2.19; p < .001), pain was registered as a complaint. Combined bladder and digestive problems accounted for 68% of complaints in all cases (n = 507) and controls (n = 555), p = 0,024, and p = 0,298. 77 percent (cases = 621; controls = 595) of the 1,578 women encountered more than one type of symptoms. There were complaints of abdominal and pelvic symptoms along with discomfort in both cases (n = 206) and controls (n = 153); OR 1.54 (CI 1.19 to 1.99; p = .001). In 14% of women, abdominal and pelvic symptoms of pain and digestive symptoms were included in the second mixture (cases n = 99; controls n = 67); OR 1.58 (CI 1.13 to 2.22; p = .008). The majority of related pre-diagnosed symptoms examined for the study were encountered by sixty percent (n=473) of women with ovarian cancer.
Some recurrent symptoms associated with abdominal and pelvic as well as pain tend to suggest an association with ovarian cancer, indicating that knowledge of the symptoms remains important to this late-stage diagnosed disease and currently lacks routine screening methods to help early detection.