Fact checked byRichard Smith

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February 07, 2023
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OTC medication purchases may predict future ovarian cancer diagnosis

Fact checked byRichard Smith
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Up to 8 months before diagnosis, women with ovarian cancer purchased more over-the-counter pain and indigestion medications vs. women without ovarian cancer, according to findings of an observational case-control study.

“The take-home message from our study is that ovarian cancer patients are buying more pain and indigestion medication about 8 months before diagnosis,” James M. Flanagan, PhD, BSc, reader in epigenetics in the department of surgery and cancer at Imperial College London, told Healio. “This is compared with when they reported recognizing their cancer symptoms at about 4.5 months before diagnosis and their first general practitioner visit about these symptoms occurring on average about 3.5 months before their diagnosis. The study shows that there are several months where patients are managing their symptoms with over-the-counter medication.”

Data derived from Brewer HR, et al. JMIR Public Health Surveill. 2023;doi:10.2196/41762.
Data derived from Brewer HR, et al. JMIR Public Health Surveill. 2023;doi:10.2196/41762.

Flanagan and colleagues recruited U.K. women who had a loyalty card from at least one of the retailers participating in the study. The researchers identified women diagnosed with ovarian cancer through recruitment from 12 National Health Service (NHS) clinics in England, Scotland and Wales between Nov. 1, 2019, and Jan. 31, 2022. Women without a diagnosis were recruited through social media, email from a participating retailer, word of mouth and through the Voice Global advocacy network from Sept. 1, 2020, to May 31, 2021.

The researchers analyzed up to 6 years of purchasing history tracked through two retailers’ loyalty card programs. They administered questionnaires to participants to identify ovarian cancer risk factors and shopping habits.

In total, 153 women with ovarian cancer and 120 women without ovarian cancer were eligible for analyses of shopping habits in association with ovarian cancer diagnosis.

Compared with women who did not have a diagnosis of ovarian cancer, women who received a diagnosis purchased significantly more pain and indigestion medications in the 6 months prior to diagnosis (OR = 1.05; 95% CI, 1.01-1.1). At 8 months, the statistical discrimination between women with vs. without ovarian cancer in the purchase of these medications was greatest at 8 months (OR = 2.91; 95% CI, 2.07-4.12).

Adjusted analyses of purchases of only pain medication were associated with ovarian cancer diagnosis in 19 months (adjusted OR = 1.18; 95% CI, 1.05-1.32). Additional analyses of only purchases of indigestion medication were associated with diagnosis in 9 months (OR = 1.38; 95% CI, 1.04-1.83).

In receiver operating characteristic curve analyses of indigestion medication purchases, the greatest area under the curve occurred at 13 months before diagnosis (AUC = 0.65; 95% CI, 0.57-0.73). Accounting for early-stage diagnosis, the AUC improved (AUC = 0.72; 95% CI, 0.6-0.84).

James M. Flanagan, PhD, BSc
James M. Flanagan

“We have identified a potential data source that might be useful in alerting individuals to potential symptoms they should be discussing with their general practitioner, and hopefully in doing so, get ovarian cancer patients diagnosed earlier than they might otherwise have done,” Flanagan said.