Introduction:  The absence of effective screening for early detection of ovarian cancer and the non-specific symptoms associated with this disease mean that timely diagnosis is difficult.  In Canada, an estimated 65-70% of ovarian cancer cases are diagnosed at advanced stages, when 3-year net survival ranges from 31.9% in Nova Scotia to 38.6% in Alberta.  There is evidence that time to diagnosis (the time interval between first presentation to the healthcare system for ovarian cancer symptoms and diagnosis) plays a role in ovarian cancer outcomes such as survival, patient satisfaction, and quality of life.  This study will examine time to diagnosis and barriers to timely diagnosis for ovarian cancer in Nova Scotia, and which subgroups are at a higher risk of longer time to diagnosis.

Methods:  This study uses data from the Nova Scotia Cancer Registry and linked administrative and census data.  The study population includes all individuals diagnosed with epithelial ovarian cancer in Nova Scotia from 2007-2016.  Demographic, tumour, and healthcare system factors associated with time to diagnosis exceeding the 75th percentile will be determined using modified Poisson regression models.  Healthcare system use during this time interval will be descriptively analyzed, including the number of physician visits, number and types of physicians seen, and proportion whose first presentation to the healthcare system was to the emergency department.

Anticipated impact:  Reducing time to diagnosis has the potential to improve survival and other patient outcomes.  The findings from this study can be used to develop guidance and resources for primary care providers to streamline referrals and investigations for potential ovarian cancer cases.  Identifying groups at risk for longer time to diagnosis can provide a basis for interventions to improve care for these groups.  There is currently no literature on the diagnostic process for ovarian cancer in Nova Scotia.