Emergency admissions associated with advanced ovarian cancer at diagnosis

And rates of diagnosis after an emergency admission are even higher among women who are young, old, frail, or who live in areas of deprivation, the findings indicate.

Ovarian cancer is the eighth most common female cancer worldwide, taking the lives of more than 200,000 women every year, note the researchers, who add that it's not easy to diagnose, because it shares several symptoms with common benign conditions.

In a bid to improve earlier diagnosis, the researchers set out to identify key factors associated with the risk of an ovarian cancer diagnosis within 28 days of an emergency hospital admission.

They drew on national cancer registry data for all 28,204 adult women diagnosed with the disease in England between 1 January 2017 and 31 December 2021, which were then linked to hospital admission records.

Among the 3372 women who were very frail, denoted by a SCARF index of "severe frailty", more than two thirds (2313; nearly 69%) were diagnosed after an emergency admission. This compares with 2891 (29%) of the 9912 women who weren't categorised as frail (SCARF index of "fit").

Diagnosis after an emergency admission was also 36% more likely in 18 to 29 year olds (209 of 490; 43%), and 25% more likely in older (80+) women (2952 of 5379; 55%) than it was among women in their 60s (2319 of 6402; just over 36%).

"The risk of being diagnosed with ovarian cancer after an emergency admission was higher in younger women, despite having higher rates of early stage low grade…cancers-factors associated with lower rates of ovarian cancer diagnosis following emergency admission," highlight the researchers, possibly because ovarian cancer isn't regarded as a young woman's disease, they speculate.

Women diagnosed after an emergency admission were also 3 times less likely to have slow growing tumours (958 of 2224;14.5%) than women who weren't admitted as an emergency (2892 of 11,946; just over 24%).

This is an observational study, and no firm conclusions can be drawn about cause and effect, added to which, the researchers acknowledge various limitations to their findings. For example, they didn't have complete information on the presence of co-existing conditions and cancer stage and grade, nor did they have any information on the women's primary care use before admission.

"Concerted action, where possible with support from international collaborations, is needed to improve referral and diagnostic pathways, with a focus on increasing patient awareness, improving early recognition of alarm symptoms, handling the prioritisation of waiting lists, and developing efficient diagnostic pathways that can provide a timely service to the many women with non-specific symptoms," they conclude.

Source:

BMJ Group

Journal reference:

Zachou, G., et al. (2026). Ovarian cancer diagnosis within 28 days after an emergency admission to hospital: national population-based study of patient risk factors and cancer characteristics using routinely collected data in England. BMJ Oncology. DOI: 10.1136/bmjonc-2025-001053. https://bmjoncology.bmj.com/content/5/2/e001053