Table 2.
ID | Agea | Stagea | Histology | Routine healthcareb | Referral pathwayc | Symptoms | Providers consulted | Appraisal and help-seeking duration (months) | Diagnostic interval duration (months) | Pre-treatment interval duration (months) | Total MPT interval duration (months) | Time from diagnosis to interview (years) |
---|---|---|---|---|---|---|---|---|---|---|---|---|
5 | 55 | IV | SC NOS | Yes | Secondary | FS: urinary frequency RFH: urinary frequency, incontinence, bloating, back pain, palpable mass | 1st gastroenterologist, naturopath, 2nd gastroenterologist (×2) | 12.17 | 45 | 0.13 | 57.30 | 2.66 |
4 | 64 | IV | SC NOS | No | Secondary | FS: abdominal pain, bloating and flatulence, RFH: lump in armpit | PCP, general surgeon, radiologist | 12.17 | 0.63 | 0.33 | 13.13 | 2.82 |
1 | 66 | IV | HGSC | Yes | Direct | RFH: rapid weight gain | PCP | 0.23 | NE | 0.40 | 0.63 | 1.42 |
12 | 78 | IV | SC NOS | No | Secondary |
FS: weight gain RFH: abdominal pain |
ED physician, outpatient physician NOS | 12 | 0.33 | 0.20 | 12.53 | 1.33 |
11 | 68 | IV | HGSC | Yes | Secondary | RFH: difficulty breathing | PCP, ED physician | 3 | 0.23 | 1.00 | 4.23 | 0.71 |
9 | 70 | IV | C NOS | Yes | Secondary | FS/RFH: neck mass | PCP, ENT | 1.37 | 0.6 | 0.03 | 2.00 | 0.84 |
10 | 69 | IV | HGSC | Yes | Secondary | RFH: difficulty breathing | Urgent care provider, ED physician, PCP | NA | 0.25 | 0.40 | 0.65 | 0.62 |
13 | 29 | III | Dys | Yes | Direct |
FS: tongue sores (“immune reaction”) RFH: abnormal periods, weight gain |
PCP | 29.43 | 12 | 0.20 | 41.63 | 0.80 |
14 | 72 | III | HGSC | Yes | Secondary | RFH: bladder discomfort | Gynecologist, PCP, initial gynecologist | 2 | 0.97 | 0.13 | 3.10 | 1.12 |
8 | 48 | III | Dys | Yes | Secondary | FS/RFH: cough | Urgent care provider, PCP, pulmonologist | 0.5 | 1.9 | 0.03 | 2.43 | 1.30 |
15 | 59 | III | HGSC | Yes | Direct | RFH: abdominal pain | PCP | NA | 0.75 | 0.40 | 1.15 | 1.13 |
2 | 53 | II | SC NOS | Yes | Direct |
FS: urinary incontinence, back pain RFH: vaginal bleeding |
Midwife | 0.33 | 0.17 | 0.43 | 0.93 | 2.21 |
7 | 46 | I | SC NOS | Yes | ED Direct |
FS: urinary incontinence, back pain RFH: back pain, nausea |
Massage therapist, ED physician | 54 | 0 | 0.57 | 54.57 | 0.79 |
6 | 57 | I | EA NOS | No | ED Direct |
FS: abdominal pain RFH: worsening of abdominal pain, and dry heaving |
ED physician | 1.1 | 0.1 | 0.03 | 1.23 | 3.36 |
Abbreviations: Unk Unknown, HGSC high grade serous carcinoma, SC serous carcinoma, EA endometrioid adenocarcinoma, Dys dysgerminoma, C carcinoma, NOS not otherwise specified, RFH reason for help-seeking, FS first symptom, PCP primary care provider, ED emergency department, ENT ear nose and throat, NE could not estimate based on transcripts, NA not applicable, Dx diagnosis. aAge and stage defined at diagnosis. bRoutine healthcare defined by seeing a health care provider for routine care within 12 months of diagnosis. cReferral pathways were defined as follows: “direct” patients were seen by an outpatient provider and directly referred by the same provider to gynecologic oncology; “secondary” patients consulted with ≥2 providers prior to receiving a referral to gynecologic oncology; “ED direct” patients first sought help in the emergency department and were directly referred from the ED to gynecologic oncology. Durations of the MPT intervals (Columns 9–13) were estimated from patient narratives. The aggregate appraisal and help-seeking interval was estimated from a patient’s first detection of a symptom to consult with a healthcare provider. The diagnostic interval was defined from first consult with a healthcare provider to receipt of ovarian cancer diagnosis. The pre-treatment interval was defined from the time of ovarian cancer diagnosis to the start of treatment