Reid Frances, Bhatla Neerja, Oza Amit M, Blank Stephanie V, Cohen Robin, Adams Tracey, Benites Amanda, Gardiner Diane, Gregory Sylvia, Suzuki Makiko, Jones Annwen
Every Woman Study, World Ovarian Cancer Coalition, Toronto, Ontario, Canada
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Int J Gynecol Cancer. 2021 Feb;31(2):238-244. doi: 10.1136/ijgc-2019-000983. Epub 2020 Jun 14.
With the global incidence of ovarian cancer set to rise by 55% to 371 000 per year by 2035, current 5-year survival rates below 50%, and 15% of women with ovarian cancer dying within 2 months of diagnosis, urgent action is required to improve survival and quality of life.
To deal with the evidence gap relating to the experience of women with the disease around the globe and identify opportunities to drive progress.
The study included a review of global trends in incidence, mortality, and survival (October 2017); qualitative interviews with women and clinicians in 16 countries (December 2017); and an online survey for women available in 15 different languages (open for 2 months, March to early May 2018). Women were eligible to participate if they had been diagnosed in the previous 5 years and were proficient in one of the 15 languages offered.
A total of 1531 women from 44 countries took part in the analysis. On average, 69.1% of women were not aware of ovarian cancer before their own diagnosis, varying from 50.9% (Hungary) to 86.4% (Brazil). A total of 78.3% of symptomatic women sought medical help, varying from 62.8% (Japan) to 87.7% (UK). Fewer than half of the women visited a doctor within 1 month (46.3%) of experiencing symptoms, varying from 38.5% (USA) to 77.3% (Germany), and a quarter of women waited 3 months or more. On average, 43.2% of women were diagnosed within 1 month of visiting a doctor, ranging from 30% (UK) to 62.3% (Italy). The average estimated time from experiencing symptoms to diagnosis was 31 weeks, but this ranged from 21.3 (Germany) to 39.7 (Brazil). Rates of post-diagnosis genetic testing ranged from 5.0% (Japan) to 79.1% (USA). Clinicians indicated that access to specialist treatment in high-volume centers varies greatly by country and region.
The findings of this study identify some of the major challenges and opportunities to improve the time to diagnosis and management of women with ovarian cancer. These problems vary widely by country, and reducing the variability is an important first step towards improving outcomes for women with ovarian cancer.
随着全球卵巢癌发病率预计到2035年将上升55%，达到每年37.1万例，目前5年生存率低于50%，15%的卵巢癌女性在确诊后2个月内死亡，因此迫切需要采取行动来提高生存率和生活质量。
解决全球范围内卵巢癌女性患者经历方面的证据空白，并确定推动进展的机会。
该研究包括对发病率、死亡率和生存率的全球趋势进行回顾（2017年10月）；对16个国家的女性和临床医生进行定性访谈（2017年12月）；以及针对女性开展一项提供15种不同语言版本的在线调查（开放2个月，2018年3月至5月初）。如果女性在过去5年内被确诊且精通所提供的15种语言之一，则有资格参与。
来自44个国家的1531名女性参与了分析。平均而言，69.1%的女性在自己被诊断之前不知道卵巢癌，这一比例在匈牙利为50.9%，在巴西为86.4%。有症状的女性中，共有78.3%寻求医疗帮助，这一比例在日本为62.8%，在英国为87.7%。不到一半的女性在出现症状后的1个月内（46.3%）去看了医生，这一比例在美国为38.5%，在德国为77.3%，四分之一的女性等待了3个月或更长时间。平均而言，43.2%的女性在看医生后的1个月内被确诊，范围从英国的30%到意大利的62.3%。从出现症状到确诊的平均估计时间为31周，但在德国为21.3周，在巴西为39.7周。确诊后基因检测的比例从日本的5.0%到美国的79.1%不等。临床医生表示，在高容量中心获得专科治疗的机会因国家和地区而异。
本研究的结果确定了改善卵巢癌女性患者诊断时间和管理方面的一些主要挑战和机会。这些问题在不同国家差异很大，减少这种差异是改善卵巢癌女性患者治疗结果的重要第一步。
