Estimating the Prevalence of Ovarian Cancer Symptoms in Women Aged 50 Years or Older: Problems and Possibilities

Am J Epidemiol. 2016 Nov 1;184(9):670-680. doi: 10.1093/aje/kww086. Epub 2016 Oct 13.


Diagnostic testing is recommended in women with "ovarian cancer symptoms." However, these symptoms are nonspecific. The ongoing Diagnosing Ovarian Cancer Early (DOVE) Study in Montreal, Quebec, Canada, provides diagnostic testing to women aged 50 years or older with symptoms lasting for more than 2 weeks and less than 1 year. The prevalence of ovarian cancer in DOVE is 10 times that of large screening trials, prompting us to estimate the prevalence of these symptoms in this population. We sent a questionnaire to 3,000 randomly sampled women in 2014-2015. Overall, 833 women responded; 81.5% reported at least 1 symptom, and 59.7% reported at least 1 symptom within the duration window specified in DOVE. We explored whether such high prevalence resulted from low survey response by applying inverse probability weighting to correct the estimates. Older women and those from deprived areas were less likely to respond, but only age was associated with symptom reporting. Prevalence was similar in early and late responders. Inverse probability weighting had a minimal impact on estimates, suggesting little evidence of nonresponse bias. This is the first study investigating symptoms that have proven to identify a subset of women with a high prevalence of ovarian cancer. However, the high frequency of symptoms warrants further refinements before symptom-triggered diagnostic testing can be implemented.

Keywords: mail survey; nonresponse; nonresponse bias; ovarian cancer symptoms; prevalence.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / standards
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Humans
  • Middle Aged
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / epidemiology*
  • Prevalence
  • Quebec / epidemiology
  • Surveys and Questionnaires
  • Symptom Assessment