Factors Associated with Time to Endometriosis Diagnosis in the United States

Abstract

Time to endometriosis diagnosis appears to have shortened in the US. Better patient and physician education regarding symptomatology may contribute to further gains.

Clinical diagnosis of endometriosis: a call to action

“…By shifting the paradigm to the patient rather than the lesion, the path to clinical diagnosis has the potential to be more inclusive with reduced diagnostic delay. Indeed, Soliman et al 18 reported diagnosing endometriosis by nonsurgical methods shortened the mean time from first consultation to diagnosis compared with surgical diagnosis. This shift, however, requires clinical diagnostic methodologies that accurately identify endometriosis.…”

“…Although a detailed review of endometriosis in adolescents is beyond the scope of this discussion, it is noteworthy that endometriosis occurs in adolescents and that patients who are younger at the time of symptom onset experience longer diagnostic delays than older patients. 17,18 This delay is attributed to prolonged time before seeking treatment and a longer interval between first clinical consultation and referral or diagnosis. It is important that clinicians evaluate symptoms that merit suspicion in adolescents as seriously as in adults.…”

“…42 Implementing clinical diagnosis Clinical diagnosis is already applied in clinical practice, albeit inconsistently and without standardization. 2,18 In an effort to provide a unified, practical approach to clinically diagnosing endometriosis, we have developed an algorithm informed by evidence in the literature and clinical experience (Figure 1). The proposed algorithm uses techniques readily available to most practitioners and allows clinicians to initiate treatment without delay or invasive procedures.…”

“…Among those who ultimately receive a successful definitive diagnosis, contemporary literature describes delays from symptom onset to diagnosis ranging from 4 to 11 years. 5,14e18 Several factors exacerbate this delay, 14,15,17,18 including "normalization" of symptoms and misdiagnosis. 15 The presence of diagnostic delays is a worldwide phenomenon, occurring even in countries with universal healthcare.…”

Healthcare Consumption and Cost Estimates Concerning Swedish Women with Endometriosis

“…For practical and economic reasons, this is not always possible, which could be a factor behind the observed diagnostic delay, especially in primary care [1]. The delay can be up to 10 years from symptom onset to diagnosis [4][5][6][7].…”