Skip to main content
Log in

Diagnostic delay, quality of life and patient satisfaction among women diagnosed with endometrial or ovarian cancer: a nationwide Danish study

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Background

This study investigates the association between diagnostic delay (total delay), quality of life (QoL) and patient satisfaction, and the associations between QoL and patient satisfaction scores and survival for women diagnosed with ovarian or endometrial cancer.

Methods

A questionnaire survey was conducted among 723 women diagnosed with ovarian or endometrial cancer from 2006 to 2007; 453 women were chosen to participate in the study. Data on total delay (number of weeks between first cancer symptom and initiation of treatment) were available from 353 women.

Results

Experiencing longer total delay was associated with reduced overall QoL and appetite loss among ovarian cancer patients, while longer total delay was associated with reduced overall QoL, reduced role and social functioning, and increased fatigue, insomnia and constipation among endometrial cancer patients. Likewise, longer total delay was associated with decreased patient satisfaction for both cancer types. For survival and QoL scores, worse scores for pain were statistically significantly associated with reduced survival for women diagnosed with ovarian cancer, while reduced overall QoL, physical, role and emotional functioning as well as increased nausea and vomiting, pain, dyspnoea and appetite loss were associated with reduced survival for women diagnosed with endometrial cancer. For survival and patient satisfaction, associations were not significant when adjusted for diagnosis, age, cancer stage and radicality of operation.

Conclusions

We found that few QoL measures were associated with total delay and survival for ovarian cancer, while a number of associations were found between QoL, total delay and survival for endometrial cancer patients. This supports the hypothesis that long total delay may influence QoL and survival for some cancer patients. Reduced patient satisfaction with the diagnostic phase was also statistically significantly associated with long total delay, highlighting that total delay is an important component in patients’ evaluation of the care they receive.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Blumenthal, D. (1996). Part 1: Quality of care—What is it? New England Journal of Medicine, 335, 891–894.

    Article  PubMed  CAS  Google Scholar 

  2. Neal, R. D. (2009). Do diagnostic delays in cancer matter? Brit. J. Cancer, 101(Suppl 2), S9–S12.

    Article  PubMed  Google Scholar 

  3. Richards, M. A., Westcombe, A. M., Love, S. B., Littlejohns, P., & Ramirez, A. J. (1999). Influence of delay on survival in patients with breast cancer: A systematic review. Lancet, 353, 1119–1126.

    Article  PubMed  CAS  Google Scholar 

  4. Neal, R. D., Allgar, V. L., Ali, N., Leese, B., Heywood, P., Proctor, G., et al. (2007). Stage, survival and delays in lung, colorectal, prostate and ovarian cancer: comparison between diagnostic routes. British Journal of General Practice, 57, 212–219.

    PubMed  Google Scholar 

  5. Crawford, S. C., Davis, J. A., Siddiqui, N. A., de Caestecker, L., Gillis, C. R., Hole, D., et al. (2002). The waiting time paradox: Population based retrospective study of treatment delay and survival of women with endometrial cancer in Scotland. BMJ, 325, 196.

    Article  PubMed  Google Scholar 

  6. Rupassara, K. S., Ponnusamy, S., Withanage, N., & Milewski, P. J. (2006). A paradox explained? Patients with delayed diagnosis of symptomatic colorectal cancer have good prognosis. Colorectal Dis, 8, 423–429.

    Article  PubMed  CAS  Google Scholar 

  7. Schwartz, C. E., & Sprangers, M. A. (2002). An introduction to quality of life assessment in oncology: The value of measuring patient-reported outcomes. American Journal of Managed Care, 8, S550–S559.

    PubMed  Google Scholar 

  8. Cella, D. F., & Tulsky, D. S. (1990). Measuring quality of life today: Methodological aspects. Oncology (Williston Park), 4, 29–38.

    CAS  Google Scholar 

  9. Chow, A., Mayer, E. K., Darzi, A. W., & Athanasiou, T. (2009). Patient-reported outcome measures: The importance of patient satisfaction in surgery. Surgery, 146, 435–443.

    Article  PubMed  Google Scholar 

  10. Coates, A., Porzsolt, F., & Osoba, D. (1997). Quality of life in oncology practice: Prognostic value of EORTC QLQ-C30 scores in patients with advanced malignancy. European Journal of Cancer, 33, 1025–1030.

    Article  PubMed  CAS  Google Scholar 

  11. Maisey, N. R., Norman, A., Watson, M., Allen, M. J., Hill, M. E., & Cunningham, D. (2002). Baseline quality of life predicts survival in patients with advanced colorectal cancer. European Journal of Cancer, 38, 1351–1357.

    Article  PubMed  CAS  Google Scholar 

  12. Gotay, C. C., Kawamoto, C. T., Bottomley, A., & Efficace, F. (2008). The prognostic significance of patient-reported outcomes in cancer clinical trials. Journal of Clinical Oncology, 26, 1355–1363.

    Article  PubMed  Google Scholar 

  13. Robinson, K. M., Ottesen, B., Christensen, K. B., & Krasnik, A. (2009). Diagnostic delay experienced among gynecological cancer patients: A nationwide survey in Denmark. Acta Obstetricia et Gynecologica Scandinavica, 88, 685–692.

    Article  PubMed  Google Scholar 

  14. The Danish Cancer Society. (2006) A cancer patients world.

  15. Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85, 365–376.

    Article  PubMed  CAS  Google Scholar 

  16. Benedet, J. L., Bender, H., Jones, H., I. I. I., Ngan, H. Y., & Pecorelli, S. (2000). FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO committee on gynecologic oncology. International Journal of Gynaecology & Obstetrics, 70, 209–262.

    Article  CAS  Google Scholar 

  17. Thind, A., Hoq, L., Diamant, A., & Maly, R. C. (2010). Satisfaction with care among low-income women with breast cancer. Journal of Womens Health (Larchmt), 19, 77–86.

    Article  Google Scholar 

  18. Montazeri, A. (2009). Quality of life data as prognostic indicators of survival in cancer patients: an overview of the literature from 1982 to 2008. Health and Quality of Life Outcomes, 7, 102.

    Article  PubMed  Google Scholar 

  19. Greimel, E., Daghofer, F., & Petru, E. (2011). Prospective assessment of quality of life in long-term ovarian cancer survivors. International Journal of Cancer, 128, 3005–3011.

    Article  CAS  Google Scholar 

  20. Carey, M. S., Bacon, M., Tu, D., Butler, L., Bezjak, A., & Stuart, G. C. (2008). The prognostic effects of performance status and quality of life scores on progression-free survival and overall survival in advanced ovarian cancer. Gynecologic Oncology, 108, 100–105.

    Article  PubMed  CAS  Google Scholar 

  21. Gupta, D., Grutsch, J. F., & Lis, C. G. (2008). Patient satisfaction with quality of life as a prognostic indicator in ovarian cancer patients treated in an integrative treatment setting. Journal of the Society for Integrative Oncology, 6, 98–104.

    PubMed  Google Scholar 

  22. Bezjak, A., Tu, D., Bacon, M., Osoba, D., Zee, B., Stuart, G., et al. (2004). Quality of life in ovarian cancer patients: Comparison of paclitaxel plus cisplatin, with cyclophosphamide plus cisplatin in a randomized study. Journal of Clinical Oncology, 22, 4595–4603.

    Article  PubMed  CAS  Google Scholar 

  23. Groenvold, M., Klee, M. C., Sprangers, M. A., & Aaronson, N. K. (1997). Validation of the EORTC QLQ-C30 quality of life questionnaire through combined qualitative and quantitative assessment of patient-observer agreement. Journal of Clinical Epidemiology, 50, 441–450.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank Lone Kjeld Petersen, Managing Surgeon, Department of Gynecology and Obstetrics, Skejby Hospital, Niels Kryger-Baggesen, PhD, Chief Surgeon, Department of Gynecology and Obstetrics, Odense University Hospital, Lene Lundvall, Managing Surgeon, Department of Gynecology and Obstetrics, Copenhagen University Hospital and Poul Jaszczak, Chief Surgeon, Department of Gynecology and Obstetrics, Herlev Hospital for their valuable help in identifying patients for the study. The study was supported financially by the Psychosocial Research Foundation, Danish Cancer Society (Grant 00 253 110 9310), the Health Insurance Foundation , the Ministry of Welfare’s Development and Analyses Foundation and the NOVO Nordic Foundation.

Conflict of interest

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kirstine M. Robinson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Robinson, K.M., Christensen, K.B., Ottesen, B. et al. Diagnostic delay, quality of life and patient satisfaction among women diagnosed with endometrial or ovarian cancer: a nationwide Danish study. Qual Life Res 21, 1519–1525 (2012). https://doi.org/10.1007/s11136-011-0077-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-011-0077-3

Keywords

Navigation