Evidence map›Paper›PMID 38556698›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2024

Investigating harms of testing for ovarian cancer - psychological outcomes and cancer conversion rates in women with symptoms of ovarian cancer: A cohort study embedded in the multicentre ROCkeTS prospective diagnostic study.

Fong Lien Kwong, Caroline Kristunas, Clare Davenport, Ridhi Aggarwal, Jon Deeks, Sue Mallett, Sean Kehoe, Dirk Timmerman, Tom Bourne, Hilary Stobart and 7 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BJOG : an international journal of obstetrics and gynaecology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
4.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 9 institutions in 4 countries.

Fong Lien KwongInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0002-6245-2358
Caroline KristunasInstitute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
Clare DavenportInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Ridhi AggarwalInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Jon DeeksInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Sue MallettCentre for Medical Imaging, University College London, London, UK.
Sean KehoeSt Peter's College, University of Oxford, Oxford, UK.
Dirk TimmermanDepartment of Development and Regeneration, KU Leuven, Leuven, Belgium.
Tom BourneDepartment of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
Hilary StobartPatient Representative, Birmingham, UK.
Richard NealUniversity of Exeter Medical School, University of Exeter, Exeter, UK.
Usha MenonInstitute of Clinical Trials and Methodology, University College London, London, UK.
Alex Gentry-MaharajInstitute of Clinical Trials and Methodology, University College London, London, UK.
Lauren SturdyInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Ryan OttridgeInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Sudha SundarPan Birmingham Gynaecological Cancer Centre, City Hospital, Birmingham, UK.ORCID https://orcid.org/0000-0002-5843-3015
ROCkeTS collaborators
University of Birmingham · GBBirmingham City Hospital · GBMRC Clinical Trials Unit at UCL · GBBirmingham Community Healthcare NHS Trust · GBImperial College London · GBKU Leuven · BESaint Peter's University · USUniversity College London · GBUniversity of Exeter · GB

Funding

Department of Health 13/13/01Health Technology Assessment ProgrammeNational Institute for Health and Care Research
6 · The paper itself

Abstract

objectiveTo investigate psychological correlates in women referred with suspected ovarian cancer via the fast-track pathway, explore how anxiety and distress levels change at 12 months post-testing, and report cancer conversion rates by age and referral pathway.

designSingle-arm prospective cohort study.

settingMulticentre. Secondary care including outpatient clinics and emergency admissions. POPULATION: A cohort of 2596 newly presenting symptomatic women with a raised CA125 level, abnormal imaging or both.

methodsWomen completed anxiety and distress questionnaires at recruitment and at 12 months for those who had not undergone surgery or a biopsy within 3 months of recruitment.

main outcome measuresAnxiety and distress levels measured using a six-item short form of the State-Trait Anxiety Inventory (STAI-6) and the Impact of Event Scale - Revised (IES-r) questionnaire. Ovarian cancer (OC) conversion rates by age, menopausal status and referral pathway.

resultsOverall, 1355/2596 (52.1%) and 1781/2596 (68.6%) experienced moderate-to-severe distress and anxiety, respectively, at recruitment. Younger age and emergency presentations had higher distress levels. The clinical category for anxiety and distress remained unchanged/worsened in 76% of respondents at 12 months, despite a non-cancer diagnosis. The OC rates by age were 1.6% (95% CI 0.5%-5.9%) for age <40 years and 10.9% (95% CI 8.7%-13.6%) for age ≥40 years. In women referred through fast-track pathways, 3.3% (95% CI 1.9%-5.7%) of pre- and 18.5% (95% CI 16.1%-21.0%) of postmenopausal women were diagnosed with OC.

conclusionsWomen undergoing diagnostic testing display severe anxiety and distress. Younger women are especially vulnerable and should be targeted for support. Women under the age of 40 years have low conversion rates and we advocate reducing testing in this group to reduce the harms of testing.

Indexed as

AnxietyOvarian NeoplasmsAdultAgedCA-125 AntigenEarly Detection of CancerFemaleHumansMiddle AgedProspective StudiesPsychological DistressReferral and ConsultationStress, PsychologicalSurveys and QuestionnairesCA-125 Antigenanxietyconversion ratesdepressiondiagnosisfast‐track pathwaysovarian cancer

Identifiers

PMID38556698
PMCPMC7616335
OpenAlexW4393384169

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.