High numbers of women diagnosed with ovarian cancer after emergency hospital admission

In the first study of its kind, Surrey clinician, Professor Agnieszka Michael, as part of her role at the National Ovarian Cancer Audit, investigated patient and cancer characteristics of those diagnosed with ovarian cancer following an emergency admission to hospital.  

Working alongside colleagues from the London School of Hygiene & Tropical Medicine and the University of Birmingham the team analysed data from over 28,000 women who were diagnosed with ovarian cancer between 2017 and 2021 to learn more about those whose cancer was identified via an emergency admission. 

Professor Agnieszka Michael, Professor of Oncology, at the University of Surrey said: 

“Ovarian cancer is the eighth most common female cancer worldwide, with close to 200,000 women dying each year.   

“Survival rates for this type of cancer are low as it is often diagnosed late, as symptoms are vague and frequently overlooked. This compounded with no effective screening programme makes it extremely difficult for women to receive a diagnosis.  

“As a result, women when they go to A&E are often extremely unwell as their cancer is more advanced and rapidly progressing, leaving many too unwell to undergo effective treatment. This needs to change and it is vital that we raise awareness of this cancer amongst women, and the medical profession to improve referral and diagnosis rates for women with a suspected ovarian cancer.” 

After in depth analysis of the data, the team found that 40 percent of women (11,377) were diagnosed with ovarian cancer within 28 days of an emergency hospital admission. Survival rates of women who received a diagnosis via this route was also impacted with one-year survival being lower (50 percent), compared to those who were diagnosed through other routes (83.3 percent). 

Worryingly ovarian cancer in women diagnosed after an emergency admission was more likely to be advanced, with only 14 percent found to have early-stage cancer (1 or 2). Women diagnosed after an emergency admission were also three times less likely to have slow growing tumours than women who weren’t admitted as an emergency. 

Furthermore, being diagnosed after an emergency admission was more common in younger women aged 18-29 years (43 percent) and in women over the age of 80 (54.9 percent) compared to women aged 60–69 (36.2 percent). Women from deprived areas were also 10 percent more likely to be diagnosed after emergency admission than those from more affluent areas.  

Professor Michael added:  

“It is very concerning that 40 percent of those with ovarian cancer only receive a diagnosis following an emergency admission to hospital. This suggests that the diagnostic pathway for this type of cancer is not effective and this needs to be remedied.  

“Although symptoms are ambiguous and could be attributed to other illnesses, ovarian cancer should always be considered and investigated fully. Early diagnosis saves lives and we need clinicians and patients to be more vigilant about they symptoms of ovarian cancer. As we have identified women who are most at risk of receiving a late diagnosis it is imperative that targeted approach is implemented to target this group.” 

This study was published in BMJ Oncology