Diagnostic Timing and Ovarian Cancer Survival

Does the wait time paradox (in which patients with severe disease are diagnosed quickly but have poor prognosis) contribute to observed associations between diagnostic timing and survival of ovarian cancer?In this cohort study using registry-linked claims data from 2359 patients with ovarian cancer, flexible nonlinear modeling demonstrated a U-shaped association between diagnostic timing and mortality, with poorer survival at very short and very long diagnostic intervals compared with intermediate intervals, patterns consistent with confounding by the wait time paradox.These findings suggest that conventional linear modeling approaches may obscure the impact of the wait time paradox, potentially masking any benefit of earlier diagnosis.

Corresponding Author: Caroline A. Thompson, PhD, MPH, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Mail Code 7435, Chapel Hill, NC 27599 (caroline.thompson@unc.edu).

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