Background: After treatment for ovarian cancer, women report health issues that may be amenable to change with dietary support. This research investigates how many women encounter a dietitian post-treatment and factors associated with dietitian service use.
Methods: We used data from a cohort of women with invasive epithelial ovarian cancer to identify socio-economic, clinical, and personal factors associated with dietitian encounter after primary treatment completion. Data were collected at regular intervals using validated questionnaires up to four years post-treatment completion. Logistic regression (LR) and generalised linear mixed models (GLMM) were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) to assess factors associated with dietitian encounter at any time-point post-treatment (LR), and in the three months prior to a follow-up questionnaire (GLMM) to assess time-varying factors.
Results: Of 819 women, 97 (12%) reported seeing a dietitian after completing primary treatment. Factors associated with dietitian encounter were being overweight (ORLR=1.7, CI=1.1-2.8), having poorer self-rated health (ORLR=2.5, CI=1.2-5.2; ORGLMM=2.3, CI=1.2-4.4) or poorer diet quality (ORLR=0.5, CI=0.2-1.0) pre-diagnosis, treatment within the public health system (ORGLMM=1.8, CI=1.2-2.7), previous support from dietetic (ORLR=3.1, CI=1.8-5.4; ORGLMM=2.8, CI=1.8-4.2) or other allied health services (ORLR=2.0, CI=1.2-3.2; ORGLMM=3.7, CI=2.4-5.5), and having progressive disease at follow-up (ORGLMM=2.2, CI=1.4-3.3). Most women (86%) with ≥3 moderate-to-severe nutrition impact symptoms did not report a dietitian encounter post-treatment.
Conclusions: Few women encounter a dietitian after treatment for ovarian cancer, including those with multiple nutrition impact symptoms. Further work is needed to engage those likely to benefit from dietitian support but less likely to seek or receive it.