In a publication in JMIR Public Health Surveillance, researchers discussed a first-of-its-kind study known as the Cancer Loyalty Card Study, which was designed to explore purchases of OTC pain and indigestion medications prior to ovarian cancer diagnosis in women with and without ovarian cancer in the United Kingdom using data from loyalty card programs.

The researchers recruited women in the UK 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 clinics in England, Scotland, and Wales between November 1, 2019, and January 31, 2022. Women without a diagnosis were recruited via social media, email from a participating retailer, word of mouth, and through the Voice Global advocacy network from September 1, 2020, to May 31, 2021.

The researchers examined up to 6 years of purchasing history. They provided the participants with questionnaires to ascertain information that assisted the researchers in identifying ovarian cancer risk factors and OTC purchasing habits.

The researchers reviewed purchasing data from 153 women with ovarian cancer and 120 women without ovarian cancer.

The authors indicated that, on average, participants with ovarian cancer began to recognize their symptoms about 4.5 months before diagnosis. Of those who visited a general practitioner (GP) to check their symptoms, the first visit occurred, on average, about 3.5 months before diagnosis.

The results revealed that purchases for pain and indigestion medication were increased among cases 8 months before diagnosis, with maximum discrimination between cases and controls 8 months before diagnosis. Additionally, an increase in indigestion medication purchases was discovered up to 9 months before diagnosis, and receiver operating characteristics analysis for indigestion medication purchases exhibited a maximum area under the curve at 13 months before diagnosis, which further improved when stratified to late-stage ovarian cancer.

The authors concluded that compared with women without ovarian cancer, those with ovarian cancer purchased more pain and indigestion medications up to 8 months before diagnosis.

The authors wrote, “Further studies with larger numbers of ovarian cancer patients, diagnosed at different stages, and more participating retailers are needed to verify these findings, which can lead to the future development of an alert system for individuals to seek medical attention for the symptoms they are experiencing sooner than they might otherwise.”

In a statement, James Flanagan, lead author and physician at Imperial College London’s Department of Surgery & Cancer, stated, “The cancer symptoms we are looking for are very common, but for some women, they could be the first signs of something more serious. Using shopping data, our study found a noticeable increase in purchases of pain and indigestion medications among women with ovarian cancer up to 8 months before diagnosis compared with women without ovarian cancer. This suggests that long before women have recognized their symptoms as alarming enough to go to the GP, they may be treating them at home.”

Dr. Flanagan added, “As we know, early diagnosis of ovarian cancer is key to improving chances of survival, we hope this research can lead to ovarian cancer symptoms being picked up earlier and improve patients’ options for treatment.”

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