Pre-diagnosis symptoms reported among endometrial cancer survivors

Objectives Timely recognition of pre-diagnosis symptoms plays a key role in early diagnosis of endometrial cancer (EC). Symptom profiles may vary by conditions such as fibroids or obesity which are differentially distributed by race. We describe pre-diagnosis symptom reporting among EC survivors by race, fibroids history, and body mass index (BMI). Methods We calculated prevalence ratios (PR) and 95% confidence intervals (CI) for 6 menstrual and 7 non-menstrual self-reported, pre-diagnosis symptoms using Poisson regression. We assessed participants' pre-diagnosis knowledge about postmenopausal bleeding and reporting of symptoms to healthcare providers. Results Among 639 Carolina Endometrial Cancer Study participants, 36% self-identified as Black or African American and 64% as White. Women with fibroids (versus without) were more likely to report heavy periods (PR = 1.24, 95% CI 1.09–1.40), periods of >7 days (PR = 1.36, 95% CI 1.08–1.71), and non-menstrual symptoms (PR = 1.15, 95% CI 1.05–1.26). Women with a BMI >30 kg/m 2 (versus ≤30) were more likely to report both menstrual (PR = 1.08, 95% CI 1.01–1.14) and non-menstrual (PR = 1.12, 95% CI 1.01–1.25) symptoms, particularly fatigue (PR = 1.39, 95% CI 1.12–1.74). After adjustment for age, fibroids history, and BMI, reported symptom experience profiles did not vary by race. Most (90%) women who reported postmenopausal bleeding discussed their symptoms with a provider; relatively few (23%) were aware of bleeding as a potential symptom of endometrial cancer. Conclusions Pre-diagnosis symptom profiles varied by fibroids and obesity among endometrial cancer survivors. Low knowledge pertaining to postmenopausal bleeding as a potential symptom for endometrial cancer suggests opportunity for improved patient education.