Two in five women with ovarian cancer are diagnosed only after an emergency hospital admission, with a one in three chance of developing the potentially curable disease in its early stages, an analysis of data published in an open access journal found. BMJ Oncology.
And research shows that younger women, older women, frail women, or women living in poorer areas are more likely to be diagnosed after an emergency hospital admission.
Ovarian cancer is the eighth most common cancer in women worldwide, claiming the lives of more than 200,000 women each year, the researchers noted, adding that diagnosis is not easy because some symptoms are shared with common benign diseases.
To improve early diagnosis, researchers set out to identify key factors associated with the risk of being diagnosed with ovarian cancer within 28 days of emergency hospitalization.
Researchers used national cancer registry data from all 28,204 adult women diagnosed with the disease in the UK between January 1, 2017 and December 31, 2021, and linked them with hospital admission records.
Between January 2017 and December 2021, 11,377 women, just over 40% of the total, were diagnosed within 28 days of emergency admission.
Certain factors were associated with the highest risk. youth; old age. and economic hardship.
Of the 3,372 extremely frail women classified as ‘severely frail’ on the SCARF index, more than two-thirds (2,313, almost 69%) were diagnosed after an emergency admission. This compares with 2,891 (29%) of the 9,912 women who were not classified as frail (SCARF index of ‘healthy’).
The odds of being diagnosed after an emergency hospital admission were 36% higher for those aged 18 to 29 (209 of 490, 43%), and 25% more likely for women aged 80 and older (2,952 of 5379, 55%) than for women in their 60s (2319 of 6402, just over 36%).
“Despite higher rates of low-grade early-stage disease, younger women had a higher risk of being diagnosed with ovarian cancer after an emergency admission…cancer factors associated with lower ovarian cancer diagnosis rates after an emergency admission,” the researchers highlighted, possibly because ovarian cancer is not considered a disease of young women.
Similarly, women from the most deprived areas (2377 of 5823, just over 44%) were 11% more likely to be diagnosed after an emergency admission (even after accounting for influencing factors such as age and frailty) than women from the least deprived areas (2367 of 6261, 38%).
The analysis showed that diseases diagnosed after emergency hospitalization were more likely to be advanced. Of the 8,438 women for whom stage information was available, only 1,155 (14%) had early-stage (1 or 2) cancer, compared with 5,442 (just over 39%) of the 13,865 women who were not diagnosed after emergency hospitalization.
Women who were diagnosed after an emergency admission were also one-third less likely to have a slow-growing tumor (958 out of 2,224, 14.5%) than women who were not admitted (2,892 out of 11,946, just over 24%).
This is an observational study, so no firm conclusions can be drawn about cause and effect, and the researchers acknowledge that their findings have a number of limitations. For example, they did not have complete information about the presence of comorbidities or the stage or grade of the cancer, nor did they have any information about the women’s primary care utilization prior to hospitalization.
The researchers suggest that there is likely an interaction between a variety of patient and health service factors behind this finding, all of which merit further investigation before improving outcomes for women with ovarian cancer.
However, this is not a UK-only problem: “The problem of ovarian cancer diagnosis after emergency admission is not limited to the UK, but also affects countries such as the US, Australia, Denmark, Norway, Canada and New Zealand, with rates ranging from approximately 20% to 50%,” the researchers note.
“Concerted action, preferably with the support of international collaboration, is needed to improve referral and diagnostic pathways, with a focus on increasing patient awareness, improving early recognition of alarm symptoms, addressing waiting list prioritization, and developing efficient diagnostic pathways that can provide timely services to many women with non-specific symptoms,” the researchers concluded.
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Reference magazines:
Zacho, G. others. (2026). Ovarian cancer diagnosis within 28 days of emergency admission: a national population-based study of patient risk factors and cancer characteristics using routinely collected data in the United Kingdom. BMJ Oncology. DOI: 10.1136/bmjonc-2025-001053. https://bmjoncology.bmj.com/content/5/2/e001053
