Examining the diagnostic process for ovarian cancer in Nova Scotia: a linked administrative data study

Abstract

Background: Due to the absence of effective screening and non-specific symptoms associated with ovarian cancer, individuals experience delays in diagnosis. This study examined time to diagnosis for ovarian cancer in Nova Scotia, factors associated with long time to diagnosis, and healthcare system use prior to diagnosis. Methods: All Nova Scotians diagnosed with epithelial ovarian cancer from 2007-2016 were identified from the Nova Scotia Cancer Registry. Independent variables were obtained from linked clinical and administrative databases and census data. Time to diagnosis and healthcare system use were descriptively analysed. Factors associated with long time to diagnosis (>75th percentile) were identified using modified Poisson regression models. Results: The median time to diagnosis was 30 days. Factors associated with long time to diagnosis included health zone, stage at diagnosis, year and site of first presentation to the healthcare system, and continuity of care. 35.7% first presented to the emergency department. The median number of physician visits and specialties seen were 4 and 3, respectively. Conclusion: Ways to streamline the diagnostic process must be identified, such as increasing awareness of ovarian cancer symptoms among the public and primary care providers.