Psychological impact of referral to an oncology hospital on patients with an ovarian mass

Pien Lof, Ellen G. Engelhardt, Mignon D. J. M. van Gent, Constantijne H. Mom, Fleur M. F. Rosier-van Dunné, W. Marchien van Baal, Harold R. Verhoeve, Brenda B. J. Hermsen, Marjolijn B. Verbruggen, Majoie Hemelaar, Jojanneke M. G. van de Swaluw, Haye C. Knipscheer, Judith A. F. Huirne, Steven M. Westenberg, Willemien J. van Driel, Eveline M. A. Bleiker, Frédéric Amant, Christianne A. R. Lok

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2 Citations (Scopus)

Abstract

Objectives In patients with an ovarian mass, a risk of malignancy assessment is used to decide whether referral to an oncology hospital is indicated. Risk assessment strategies do not perform optimally, resulting in either referral of patients with a benign mass or patients with a malignant mass not being referred. This process may affect the psychological well-being of patients. We evaluated cancer-specific distress during work-up for an ovarian mass, and patients' perceptions during work-up, referral, and treatment. Methods Patients with an ovarian mass scheduled for surgery were enrolled. Using questionnaires we measured (1) cancer-specific distress using the cancer worry scale, (2) patients' preferences regarding referral (evaluated pre-operatively), and (3) patients' experiences with work-up and treatment (evaluated post-operatively). A cancer worry scale score of ≥14 was considered as clinically significant cancer-specific distress. Results A total of 417 patients were included, of whom 220 (53%) were treated at a general hospital and 197 (47%) at an oncology hospital. Overall, 57% had a cancer worry scale score of ≥14 and this was higher in referred patients (69%) than in patients treated at a general hospital (43%). 53% of the patients stated that the cancer risk should not be higher than 25% to undergo surgery at a general hospital. 96% of all patients were satisfied with the overall work-up and treatment. No difference in satisfaction was observed between patients correctly (not) referred and patients incorrectly (not) referred. Conclusions Relatively many patients with an ovarian mass experienced high cancer-specific distress during work-up. Nevertheless, patients were satisfied with the treatment, regardless of the final diagnosis and the location of treatment. Moreover, patients preferred to be referred even if there was only a relatively low probability of having ovarian cancer. Patients' preferences should be taken into account when deciding on optimal cut-offs for risk assessment strategies.
Original languageEnglish
Pages (from-to)74-82
JournalInternational journal of gynecological cancer
Volume33
Issue number1
Early online date13 Dec 2022
DOIs
Publication statusPublished - 13 Dec 2022

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