Table 4.
Symptoms reported by study participants during 12 months prior to diagnosis (cases) or interview date (controls) by tumor histological type
| Symptoms | Controls n (%) | Cases n (%) | OR (95% CI)a | Cases by stage at diagnosis | ROC | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| localized | regional | distant | All cases |
Localized stage only |
|||||||
| n (%) | OR (95% CI) a | n (%) | OR (95% CI) a | n (%) | OR (95% CI) a | ||||||
| Serous carcinoma | |||||||||||
| No. of participants | 491(71) | 196 (29) | 21 (11) | 43 (22) | 128 (67) | ||||||
| Abdominal pain | 89 (18) | 115 (59) | 7.6 (5.1–11.5) | 13 (62) | 8.6 (3.3–22.6) | 21 (49) | 5.9 (2.9–11.7) | 78 (61) | 8.1 (5.1–12.9) | 0.80 | 0.86 |
| Distended abdomen | 17 (3) | 80 (41) | 21.0 (11.5–38.4) | 6 (29) | 10.4 (3.3–32.2) | 15 (35) | 17.8 (8.6–41.9) | 57 (45) | 24.2 (12.7–46.0) | 0.81 | 0.86 |
| Abdominal mass | 6 (1) | 35 (18) | 26.7 (10.1–70.3) | 5 (23) | 50.6 (11.8–217) | 8 (19) | 24.0 (7.2–79.2) | 21 (16) | 77.1 (9.6–76.7) | 0.86 | 0.94 |
| Abnormal bleeding | 17 (3) | 17 (9) | 4.8 (2.2–10.6) | 2 (9) | 6.0 (1.1–31.2) | 4 (9) | 3.7 (1.1–12.2) | 11 (9) | 5.7 (2.3–13.9) | 0.83 | 0.94 |
| Urinary symptoms | 107 (22) | 72 (37) | 2.1 (1.5–3.0) | 10 (48) | 3.3 (1.4–7.9) | 13 (30) | 1.6 (0.8–3.1) | 46 (36) | 2.1 (1.3–3.1) | 0.72 | 0.79 |
| Bowel symptoms | 212 (43) | 100 (51) | 1.5 (1.1–2.1) | 12 (57) | 1.8 (0.7–4.6) | 19 (44) | 1.1 (0.6–2.1) | 68 (53) | 1.6 (1.1–2.5) | 0.70 | n/s |
| Fatigue/loss of appetite | 115 (23) | 76 (39) | 2.1 (1.4–3.0) | 9 (43) | 2.5 (0.9–6.5) | 13 (30) | 1.6 (0.8–3.4) | 52 (41) | 2.1 (1.4–3.3) | 0.71 | 0.78 |
| 4-symptom index | 114 (43) | 148 (76) | 13.5 (7.9–23.1) | 15 (71) | 10.2 93.3–31.3) | 32 (74) | 14.6 (6.6–32.4) | 98 (77) | 14.5 (7.6–27.6) | 0.91 | 0.96 |
| 3-symptom index | 35 (7) | 107 (55) | 21.4 (12.2–37.7) | 10 (48) | 16.3 (5.6–47.2) | 23 (53) | 20.6 (9.5–44.7) | 72 (56) | 25.1 (13.2–48.0) | 0.91 | 0.95 |
| Endometrioid carcinoma | |||||||||||
| No. of participants | 491(85) | 75 (15) | 25 (35) | 33 (46) | 14 (19) | ||||||
| Abdominal pain | 89 (18) | 41 (55) | 8.8 (4.7–16.3) | 14 (56) | 9.3 (3.5–24.2) | 18 (55) | 8.6 (3.7–19.7) | 8 (57) | 10.2 (3.0–35.4) | 0.84 | 0.87 |
| Distended abdomen | 17 (3) | 22 (29) | 9.0 (4.0–20.1) | 8 (32) | 9.5 (3.1–28.5) | 11 (33) | 13.7 (4.9–38.1) | 3 (21) | 5.4 (1.1–23.9) | 0.80 | 0.86 |
| Abdominal mass | 6 (1) | 7 (9) | 17.2 (4.7–63.5) | 2 (8) | 17.1 (2.5–117.2) | 5 (15) | 17.6 (4.3–72.2) | 0 (0) | n/a | 0.86 | 0.92 |
| Abnormal bleeding | 17 (3) | 15 (20) | 8.6 (3.4–21.8) | 4 (16) | 8.8 (2.1–36.0) | 7 (21) | 7.5 (2.5–22.4) | 3 (21) | 10.2 (1.9–55.7) | 0.88 | 0.94 |
| Urinary symptoms | 107 (22) | 20 (27) | 1.5 (0.8–2.7) | 3 (12) | 0.5 (0.2–1.9) | 10 (30) | 1.7 (0.8–3.9) | 6 (43) | 3.5 (1.1–10.9) | n/s | n/s |
| Bowel symptoms | 212 (43) | 24 (32) | 0.6 (0.3–1.1) | 8 (32) | 0.6 (0.2–1.4) | 8 (24) | 0.4 (0.2–0.9) | 7 (50) | 1.5 (0.5–4.2) | n/s | n/s |
| Fatigue/loss of appetite | 115 (23) | 25 (33) | 1.7 (0.9–3.1) | 9 (36) | 1.9 (0.8–4.7) | 10 (30) | 1.5 (0.6–3.3) | 6 (43) | 2.7 (0.9–8.3) | n/s | n/s |
| 4-symptom indexc | 114 (23) | 55 (73) | 15.5 (6.9–34.7) | 18 (72) | 17.3 (4.8–62.3) | 26 (79) | 21.0 (7.5–58.8) | 10 (71) | 13.5 (2.9–63.4) | 0.92 | 0.95 |
| 3-symptom indexd | 35 (7) | 35 (47) | 11.6 (5.5–24.6) | 12 (48) | 13.3 (4.4–40.7) | 16 (48) | 12.5 (5.2–30.0) | 6 (43) | 8.2 (2.1–32.1) | 0.89 | 0.95 |
| Mucinous carcinoma | |||||||||||
| No. of participants | 491(92) | 45 (8) | 36 (80) | 6 (13) | 3 (7) | ||||||
| Abdominal pain | 89 (18) | 23 (51) | 5.3 (2.6–10.8) | 19 (53) | 5.0 (2.5–10.1) | 3 (50) | 4.5 (0.9–22.7) | 1 (33) | n/a | 0.84 | 0.83 |
| Distended abdomen | 17 (3) | 25 (56) | 34.8 (16.3–74.6) | 20 (56) | 34.9 (15.4–78.8) | 4 (67) | 55.8 (9.5–325) | 1 (33) | n/a | 0.91 | 0.90 |
| Abdominal mass | 6 (1) | 8 (18) | 49.5 (12.6–194.1) | 5(14) | 41.2 (9.7–175.5) | 2 (33) | 164 (11.0–175) | 1 (33) | n/a | 0.96 | 0.96 |
| Abnormal bleeding | 17 (3) | 4 (9) | 6.9 (1.8–27.3) | 3 (8) | 6.6 (1.4–30.9) | 1 (7) | 6.4 (0.5–84.9) | 0 (0) | n/a | 0.91 | 0.94 |
| Urinary symptoms | 107 (22) | 12 (27) | 1.3 (0.7–2.6) | 11 (31) | 1.6 (0.8–3.3) | 1 (17) | 0.7 (0.1–6.2) | 0 (0) | n/a | n/s | n/s |
| Bowel symptoms | 212 (43) | 15 (33) | 0.7 (0.3–1.3) | 14 (39) | 0.8 (0.4–1.7) | 1 (17) | 0.3 (0.1–1.3) | 0 (0) | n/a | n/s | n/s |
| Fatigue/loss of appetite | 115 (23) | 9 (20) | 0.8 (0.4–1.7) | 8 (22) | 0.9 (0.4–2.1) | 1 (17) | 0.7 (0.1–5.7) | 0 (0) | n/a | n/s | n/s |
| 4-symptom indexc | 114 (23) | 33 (73) | 18.1 (5.4–61.0) | 26 (72) | 18.1 (4.4–74.7) | 5 (83) | 17.3 (1.8–171) | 2 (67) | n/a | 0.95 | 0.97 |
| 3-symptom indexd | 35 (7) | 26 (58) | 33.0 (10.7–101.4) | 21 (58) | 41.2 (10.6–160) | 4 (67) | 23.4 (3.1–177) | 1 (33) | n/a | 0.96 | 0.97 |
| Clear cell carcinoma | |||||||||||
| No. of participants | 491(90) | 52 (10) | 31 (60) | 9 (17) | 12 (23) | ||||||
| Abdominal pain | 89 (18) | 19 (37) | 3.3 (1.6–6.5) | 11 (35) | 3.5 (1.5–8.3) | 2 (22) | 1.7 (0.3–9.4) | 6 (50) | 4.2 (1.3–14.1) | 0.79 | 0.82 |
| Distended abdomen | 17 (3) | 17 (33) | 12.9 (5.2–31.7) | 8 (26) | 7.3 (2.4–21.9) | 1 (11) | 2.8 (0.3–31.9) | 8 (67) | 67.3 (15.2–297) | 0.82 | 0.81 |
| Abdominal mass | 6 (1) | 8 (15) | 16.3 (4.5–59.7) | 7 (23) | 25.7 (6.4–103.0) | 0 (0) | n/a | 1 (8) | 7.2 (0.7–73.8) | 0.92 | 0.91 |
| Abnormal bleeding | 17 (3) | 6 (12) | 4.2 (1.2–15.1) | 2 (6) | 1.7 (0.2–12.1) | 3 (33) | 25.1 (3.2–195.8) | 1 (8) | 4.5 (0.3–58.1) | 0.92 | n/s |
| Urinary symptoms | 107 (22) | 16 (31) | 1.9 (0.9–3.8) | 9 (29) | 1.8 (0.8–4.4) | 3 (33) | 2.1 (0.5–9.6) | 4 (33) | 2.1 (0.6–7.2) | n/s | n/s |
| Bowel symptoms | 212 (43) | 10 (19) | 0.3 (0.1–0.7) | 4 (13) | 0.2 (0.1–0.6) | 3 (33) | 0.9 (0.2–3.8) | 3 (25) | 0.4 (0.1–1.5) | n/s | n/s |
| Fatigue/loss of appetite | 115 (23) | 18 (35) | 1.9 (0.9–3.6) | 7 (23) | 0.9 (0.4–2.5) | 5 (56) | 6.0 (1.3–27.6) | 6 (50) | 3.6 (1.1–12.4) | n/s | n/s |
| 4-symptom indexc | 114 (23) | 32 (62) | 5.9 (2.4–14.5) | 19 (61) | 5.5 (1.9–15.4) | 5 (56) | 9.2 (1.7–49.8) | 8 (67) | 6.0 (1.2–28.8) | 0.93 | 0.92 |
| 3-symptom indexd | 35 (7) | 26 (50) | 12.1 (4.6–31.8) | 14 (45) | 8.8 (2.9–26.2) | 4 (44) | 23.6 (3.8–148.2) | 8 (67) | 37.6 (6.4–222.3) | 0.94 | 0.92 |
Abbreviations: ROC, area under receiver operating curve; OR, odds ratio; CI, confidence interval
a
OR and 95% CI for a difference in reporting a given symptom between control women (OR=1.0) and women with cancer adjusted for age, ethnicity, education, parity, menopausal status, and use of contraceptive and menopausal hormones.
b
Includes any of the following symptoms: 1/distended abdomen, 2/abnormal vaginal bleeding, 3 abdominal mass, 4/abdominal pain, 5/urinary symptoms, 6/bowel irregularity or bloating, 7/fatigue or loss of appetite.
c
Includes any one of the following symptoms: 1/distended abdomen, 2/abnormal vaginal bleeding, 3/abdominal mass, 4/abdominal pain.
d
Includes any one of the following symptoms: 1/distended abdomen, 2/abnormal vaginal bleeding, 3/abdominal mass.