BACKGROUND: @entity1 with @entity43 often report having symptoms for months before diagnosis, but such findings are subject to recall bias. The aim of this study was to provide an objective evaluation of symptoms that precede a diagnosis of @entity43 . METHODS: Medicare provider claims linked to records in the California Surveillance, Epidemiology, and End Results data base were utilized to extract diagnosis and procedure codes for 1985 @entity1 age 68 years or older who resided in California with @entity43 , 6024 elderly @entity1 with localized @entity0 , and 10,941 age-matched, Medicare-enrolled @entity1 without @entity5 . Prevalence of rates of symptom-related diagnoses and procedure codes in Medicare claims records were obtained during 3-month periods up to 36 months before diagnosis of @entity43 . RESULTS: From 1 month to 3 months before @entity1 were diagnosed with @entity43 , the frequency and adjusted odds ratios (ORs) with 95% confidence intervals (95%CIs) for 4 "target symptom" code groups were: @entity490 (frequency, 30.6%; OR, 6.0; 95%CI, 5.1-6.9), abdominal swelling (frequency, 16.5%; OR, 30.9; 95%CI, 21.4-44.8), @entity344 (frequency, 8.4%; OR, 2.3; 95%CI, 1.8-3.0), and pelvic @entity158 (frequency, 5.4%; OR, 4.3; 95%CI, 2.8-6.7). The adjusted odds for abdominal swelling codes was elevated 10-12 months before diagnosis (OR, 2.4; 95%CI, 1.2-4.6) for @entity490 codes 7-9 months before diagnosis (OR, 1.3; 95%CI, 1.1-1.7). Abdominal imaging (frequency, 7.0%; OR, 1.3; 95%CI, 1.0-1.7) and pelvic imaging/ @entity10224 (frequency, 3.7%; OR, 2.4; 95%CI, 1.7-3.4) showed an elevated frequency and adjusted odds 4-6 months before diagnosis. @entity1 with claims codes for "target symptoms" 4-36 months before diagnosis were more likely to have abdominal imaging (61.1%) or gastrointestinal procedures (30.8%) than pelvic imaging/ @entity10224 (25.3%). CONCLUSIONS: @entity1 with @entity43 were more likely than @entity1 with @entity0 and @entity1 in a @entity5 -free control group to have target symptom codes (particularly abdominal swelling and @entity158 ) > 6 months before diagnosis. The evaluation of @entity1 with unexplained "target symptoms" should include pelvic imaging and/or @entity10224 .

XXXX : can we make the clinical diagnosis earlier?

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients'] @entity43 :: ('MESH:D010051', 'Disease') :: ['ovarian cancer'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity10224 :: ('94025', 'Gene') :: ['CA125'] @entity344 :: ('MESH:D005767', 'Disease') :: ['gastrointestinal symptoms'] @entity490 :: ('MESH:D015746', 'Disease') :: ['abdominal pain'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity43 :: (MESH:D010051,Disease) :: ['Ovarian cancer']
