Kwong, Fong Lien;
Kristunas, Caroline;
Davenport, Clare;
Aggarwal, Ridhi;
Deeks, Jon;
Mallett, Sue;
Kehoe, Sean;
... ROCkeTS collaborators; + view all
(2024)
Investigating harms of testing for ovarian cancer – psychological outcomes and cancer conversion rates in women with symptoms of ovarian cancer: A cohort study embedded in the multicentre ROCkeTS prospective diagnostic study.
BJOG: An International Journal of Obstetrics and Gynaecology
10.1111/1471-0528.17813.
(In press).
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Abstract
Objective: To investigate psychological correlates in women referred with suspected ovarian cancer via the fast-track pathway, explore how anxiety and distress levels change at 12 months post-testing, and report cancer conversion rates by age and referral pathway. // Design: Single-arm prospective cohort study. // Setting: Multicentre. Secondary care including outpatient clinics and emergency admissions. // Population: A cohort of 2596 newly presenting symptomatic women with a raised CA125 level, abnormal imaging or both. // Methods: Women completed anxiety and distress questionnaires at recruitment and at 12 months for those who had not undergone surgery or a biopsy within 3 months of recruitment. // Main outcome measures: Anxiety and distress levels measured using a six-item short form of the State–Trait Anxiety Inventory (STAI-6) and the Impact of Event Scale – Revised (IES-r) questionnaire. Ovarian cancer (OC) conversion rates by age, menopausal status and referral pathway. // Results: Overall, 1355/2596 (52.1%) and 1781/2596 (68.6%) experienced moderate-to-severe distress and anxiety, respectively, at recruitment. Younger age and emergency presentations had higher distress levels. The clinical category for anxiety and distress remained unchanged/worsened in 76% of respondents at 12 months, despite a non-cancer diagnosis. The OC rates by age were 1.6% (95% CI 0.5%–5.9%) for age <40 years and 10.9% (95% CI 8.7%–13.6%) for age ≥40 years. In women referred through fast-track pathways, 3.3% (95% CI 1.9%–5.7%) of pre- and 18.5% (95% CI 16.1%–21.0%) of postmenopausal women were diagnosed with OC. // Conclusions: Women undergoing diagnostic testing display severe anxiety and distress. Younger women are especially vulnerable and should be targeted for support. Women under the age of 40 years have low conversion rates and we advocate reducing testing in this group to reduce the harms of testing.
| Type: | Article |
|---|---|
| Title: | Investigating harms of testing for ovarian cancer – psychological outcomes and cancer conversion rates in women with symptoms of ovarian cancer: A cohort study embedded in the multicentre ROCkeTS prospective diagnostic study |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/1471-0528.17813 |
| Publisher version: | http://dx.doi.org/10.1111/1471-0528.17813 |
| Language: | English |
| Additional information: | Copyright © 2024 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Anxiety, conversion rates, depression, diagnosis, fast-track pathways, ovarian cancer |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10190135 |
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