Factors Associated with Time to Endometriosis Diagnosis in the United States.

BACKGROUND

We aimed to quantify the time to diagnosis among women with endometriosis in the United States (US) and to identify patient- and physician-related factors affecting diagnostic delay.

PATIENTS AND METHODS

An online cross-sectional survey was conducted from August 6, 2012, through November 14, 2012. Respondents aged 18-49 years who reported a physician's diagnosis/suspicion of endometriosis within the previous 10 years were included. Endometriosis-related symptoms and diagnostic history were captured and summarized. Univariate analyses identified factors associated with time from symptom onset to first consultation and from first consultation to diagnosis.

RESULTS

Of 638 respondents included, most (56%) reported seeking care for at least one of the following symptoms: menstrual pain (31.6%), nonmenstrual pain (27.3%), and pain during sex (7.5%). Most diagnoses (84%) were made by obstetricians/gynecologists; 49% of diagnoses were surgical versus 51% nonsurgical. Mean time from symptom onset to diagnosis was 4.4 years. Mean time to first consultation was shorter among women aged 40-49 years versus those aged <18 years (14.2 vs. 43.5 months; p < 0.0001) and those consulting for symptoms versus routine/other care (27.9, 24.9, and 28.4 months for menstrual pain, nonmenstrual pain, and pain during sex, respectively, vs. 61.4 months; all p < 0.01). Mean time from first consultation to diagnosis was shorter among women aged 40-49 years versus those aged <18 years (12.4 vs. 34.5 months; p = 0.0009) and those diagnosed by obstetricians/gynecologists versus nonobstetricians/gynecologists (21.5 vs. 40.3 months; p = 0.041).

CONCLUSIONS

Time to endometriosis diagnosis appears to have shortened in the US. Better patient and physician education regarding symptomatology may contribute to further gains.