Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia.
Department of General Practice and Primary Care, Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Australia.
J Womens Health (Larchmt). 2024 Sep;33(9):1185-1197. doi: 10.1089/jwh.2023.1160. Epub 2024 Jul 8.
Ovarian cancer is commonly diagnosed symptomatically at an advanced stage. Better survival for early disease suggests improving diagnostic pathways may increase survival. This study examines literature assessing diagnostic intervals and their association with clinical and psychological outcomes. Medline, EMBASE, and EmCare databases were searched for studies including quantitative measures of at least one interval, published between January 1, 2000 and August 9, 2022. Interval measures and associations (interval, outcomes, analytic strategy) were synthesized. Risk of bias of association studies was assessed using the Aarhus Checklist and ROBINS-E tool. In total, 65 papers (20 association studies) were included and 26 unique intervals were identified. Interval estimates varied widely and were impacted by summary statistic used (mean or median) and group focused on. Of Aarhus-defined intervals, patient (symptom to presentation, = 23; range [median]: 7-168 days) and diagnostic (presentation to diagnosis, = 22; range [median]: 7-270 days) were most common. Nineteen association studies examined survival or stage outcomes with most, including five low risk-of-bias studies, finding no association. Studies reporting intervals for ovarian cancer diagnosis are limited by inconsistent definitions and reporting. Greater utilization of the Aarhus statement to define intervals and appropriate analytic methods is needed to strengthen findings from future studies.
卵巢癌通常在晚期出现症状后被诊断出来。早期疾病的更好生存表明，改善诊断途径可能会提高生存率。本研究考察了评估诊断间隔及其与临床和心理结果关联的文献。使用 Medline、EMBASE 和 EmCare 数据库，检索了 2000 年 1 月 1 日至 2022 年 8 月 9 日期间发表的至少有一项间隔定量测量的研究。综合了间隔措施和关联（间隔、结果、分析策略）。使用奥胡斯清单和 ROBINS-E 工具评估关联研究的偏倚风险。总共纳入 65 篇论文（20 项关联研究）和 26 个独特的间隔。间隔估计值差异很大，受使用的汇总统计数据（均值或中位数）和关注的群体的影响。在奥胡斯定义的间隔中，患者（症状到就诊， = 23；范围[中位数]：7-168 天）和诊断（就诊到诊断， = 22；范围[中位数]：7-270 天）是最常见的。19 项关联研究检查了生存或分期结果，其中大多数包括 5 项低偏倚风险研究，没有发现关联。卵巢癌诊断间隔的研究受到不一致的定义和报告的限制。需要更多地利用奥胡斯声明来定义间隔和适当的分析方法，以加强未来研究的发现。
