Awareness of ovarian cancer symptoms and risk factors among women in the general population is low. Ovarian cancer is often diagnosed at late stages, when cure is difficult; consequently, heightening women's awareness of risk factors and symptoms might help to reduce delays in diagnosis. Nurses should provide women with specific information on symptoms and risk factors in educating them on ovarian cancer.

The nature and management of physical symptoms, beyond pain, in ovarian cancer survivors need further study. Specifically, QOL and psychosocial issues for long-term survivors require study. Consequences for women who undergo major tissue debulking or multiple and aggressive courses of cytotoxic treatments must be understood to facilitate intervention.

There is a paucity of research on the incidence and impact of lower body lymphedema in the gynecologic cancer population. The cornerstone of management for gynecologic cancer is cytoreductive surgery. Depending on the site of the cancer, surgery traditionally involves removal of the ovaries, fallopian tubes, uterus and cervix, accompanied with extensive node dissection throughout the pelvic cavity, and, in the case of ovarian cancer, removal of the omentum. Resection of pelvic lymph nodes and vessels, compounded by gravitational influences on lymphatic flow, can lead to lymphatic congestion that impairs mobility, raises intra-abdominal pressure, and increases abdominal and extremity girth. Lymphedema can be an indicator of recurrence and is frequently associated with toxicities such as skin breakdown, pain, neuropathy, and myopathy. Physical changes, role changes, and psychosocial issues are common symptoms reported by breast cancer survivors with lymphedema. Assessment and management strategies for upper extremity lymphedema following treatment of breast cancer cannot be directly transferred to lower extremity lymphedema affecting women with cancer of the ovary, cervix, uterus, and vulva because of limb size, volume, and location. Clinicians have anecdotally reported the presence of lower body lymphedema in many gynecologic cancer patients. Survivors have described tightness, swelling, and heaviness. Despite these clinical findings, no systematic study of lower body lymphedema in women with gynecologic cancer has been conducted. Whether lower body lymphedema is as debilitating and long-term as post-mastectomy lymphedema is not empirically known.

Although Papanicolaou test screening rates are reportedly high, a significant proportion of women remain unscreened. With recent revision of Papanicolaou test guidelines, it is critical that interventions and programs for cervical cancer directed toward low participating groups or individuals be developed. The purpose of the study was to examine factors that influence participation in cervical cancer screening by quantifying characteristics of women who engage in Papanicolaou test screening in a 12-month period. Using the 2000 National Health Interview Survey and Cancer Topical Module, the sample (N = 18,388) consisted of women who were older than 18 years. The dependent variable was nominally identified as whether a woman had had a Papanicolaou test in the last 12 months. Independent variables examined were insurance, level of education, place for care, age, race, employment, place of residence, and income level. Using logistic regression, all variables except race and income level were found to be significant for participation in cervical cancer screening (P< .000). Each variable is discussed within the framework of the Institute of Medicine model of access to personal healthcare services. Study findings provide insight and guidance for the development and implementation of methods for accessing women who have lower participation rates.