Lack of awareness a key factor in delayed diagnosis of ovarian cancer

2 Feb 2025

In South Africa, the number of cases of ovarian cancer is predicted to rise by a staggering 72.9% by 2050, underscoring the pressing need for greater awareness among women and clinicians, early detection, improved diagnostic procedures and better patient support systems.

Ovarian cancer remains one of the most formidable challenges in women’s health, ranking as the third most common gynaecological cancer in South Africa after cervical and uterine cancers.

Although less prevalent, it tragically has the highest case-fatality rate, with most women diagnosed at advanced stages of the disease. This often leads to a poorer prognosis, making it a disease that demands urgent attention.

According to the World Health Organization’s Global Cancer Observatory, ovarian cancer cases are expected to rise significantly worldwide, with developing countries seeing the sharpest increase.

In South Africa, the number of cases is predicted to rise by a staggering 72.9% by 2050, underscoring the pressing need for greater awareness among women and clinicians, early detection, improved diagnostic procedures and better patient support systems. This will help to reduce delays in seeking help and initiating treatment.

Ahead of World Cancer Day on 4 February, it is important to point out that one of the most concerning aspects of ovarian cancer is its late diagnosis. The symptoms, which often resemble those of less serious conditions, are frequently misattributed, delaying medical intervention.

Screening for ovarian cancer has also shown limited evidence to improve oncological outcomes. Consequently, many women are diagnosed at an advanced stage of the disease, where treatment options are limited and the positive outcomes are less likely.

Education

When a woman is diagnosed with ovarian cancer, the path to recovery involves not only medical treatment but also emotional, psychological and informational support. Research consistently shows that providing patients with the information they need about their diagnosis, treatment options and the long-term effects of the disease can significantly improve health outcomes and reduce anxiety.

This knowledge empowers patients to make informed decisions, engage more actively in their treatment, and, ultimately, improve their quality of life.

A 2018 study, The Every Woman Study (EWS), conducted in high-income countries, found that most ovarian cancer patients lacked crucial information about their disease. While this study shed light on the informational gaps in wealthier nations, it also revealed a profound lack of data from low- and middle-income countries (LMICs), where the majority of ovarian cancer patients reside.

Tygerberg Hospital (TBH) in Cape Town participated as one of the centres of the 2023 International EWS in a global effort to fill this gap by engaging with patients in LMICs to understand their specific informational needs.

The findings from this study were striking. At TBH, only 25% of ovarian cancer survivors had ever heard of ovarian cancer before their diagnosis and a significant number (50%) were unaware that having a family history of certain cancers, such as breast or uterine cancer, could increase their risk.

This lack of awareness is a key factor in the delayed diagnosis of ovarian cancer. If more women were informed about the risks and symptoms of ovarian cancer, they would likely seek medical attention earlier, potentially improving their chances of early detection and treatment.

Better communication

One of the most critical findings from the TBH study was that most patients relied heavily on their doctors for information. The physician-patient relationship is crucial in the management of ovarian cancer.

Patients said their doctor’s opinion was the most influential factor in deciding on treatment options. This highlights the importance of clear, compassionate and empathetic communication. Healthcare providers must be trained not only in the medical aspects of cancer care, but also in how to communicate effectively with patients about their diagnosis, treatment options and prognosis.

Sadly, many patients in South Africa and other LMICs lack access to reliable health information online. Only 15.4% of women in the study felt that they could get information on their disease in their language of choice on the internet. Of those who answered, about one out of 10 reported that they did not have access to the internet. Although an upward trend is seen, an estimated 21.1% of households in South Africa still lacked internet access in 2022.

Despite the wealth of health data online, much of it is generalised and may not be relevant or accurate for individual patients. Misinformation can cause confusion and anxiety, highlighting the importance of doctors providing tailored, specific guidance for each patient.

In addition to direct patient care, healthcare systems must also make reliable informational resources available to patients. This can help reinforce the information provided during medical consultations, ensuring that patients fully understand their diagnosis and treatment options.

Peer support

Another significant gap identified in the study was the lack of peer support. Despite the potential benefits of connecting with others who are going through similar experiences, 75% of women in the study had never met or spoken to another ovarian cancer patient.

Support groups play a crucial role in the emotional and informational well-being of cancer patients. They offer a safe space for women to share their fears, hopes and experiences, as well as to exchange valuable information about managing symptoms, coping with side effects and navigating treatment options.

Given the lack of support groups and peer connections identified in the study, there is a clear opportunity for cancer treatment centres to establish local support networks for ovarian cancer patients. Additionally, online support communities can offer women in remote or underserved areas access to social and emotional support. These groups not only provide emotional relief but can also serve as powerful platforms for advocacy and awareness.

Bridging the gap

With ovarian cancer cases set to rise in South Africa and other developing countries, proactive steps are crucial to bridge the gaps in knowledge, diagnosis and patient care. Efforts are needed to increase awareness of ovarian cancer symptoms, both in the general population and among healthcare providers. Public health campaigns that educate women on the risks and early warning signs of ovarian cancer could lead to earlier detection and, ultimately, better outcomes.

Furthermore, healthcare systems must be equipped to provide comprehensive care that addresses not only the physical but also the informational and emotional needs of patients. Training clinicians to communicate effectively with cancer patients and providing them with the resources to do so is essential.

It is also imperative that healthcare facilities invest in educational materials and support networks to help patients navigate their cancer journey.

The challenge of ovarian cancer is great, but so too is the opportunity to improve outcomes through awareness, better communication and stronger patient support systems. By prioritising education and support, we can make significant strides in improving the lives of women affected by this devastating disease.

With knowledge and compassion, we can empower patients to take control of their health and ensure that they receive the care and support they deserve. DM

Dr Celesté van Drünick is a gynaecological oncologist at Life Vincent Pallotti Hospital in Pinelands, Cape Town. This article is based in part on her recent master’s degree in gynaecologic oncology at Stellenbosch University.

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Education

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Bridging the gap