About two in five women diagnosed with ovarian cancer were only diagnosed after an emergency admission to the hospital, according to the results of a national population-based study from England that was published in BMJ Oncology.
“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,” the study authors, led by Georgia Zachou, a PhD candidate in the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom, said.
They also stressed that their findings were likely to be relevant for many other countries. “The issue of ovarian cancer diagnosis following an emergency admission is not confined to England but also affects countries such as the USA, Australia, Denmark, Norway, Canada, and New Zealand, where the rates range from about 20% to 50%,” they pointed out. “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 prioritization of waiting lists, and developing efficient diagnostic pathways that can provide a timely service to the many women with nonspecific symptoms.”
Study Methods
Researchers conducted a national population-based study to assess patient risk factors and characteristics associated with an ovarian cancer diagnosis after an emergency admission to the hospital. They sought to compare characteristics between those who were diagnosed after an emergency admission and those who were diagnosed in other situations.
All women included in the study (n = 28,204) were diagnosed with ovarian cancer in England between 2017 and 2021.
Key Findings
A total of 40.3% of women included in the study were diagnosed with ovarian cancer after an emergency admission to the hospital. An emergency-based diagnosis was more common among younger women of 18 to 29 years (42.7%; adjusted risk ratio [aRR] = 1.36; 95% confidence interval [CI] = 1.22–1.52) and older women of 80 years or older (54.9%; aRR = 1.25; 95% CI = 1.20–1.31) in comparison with women between the ages of 60 and 69 years (36.2%).
Women who lived in more deprived neighborhoods were more likely to be diagnosed after an emergency admission (44.2%) than those from less deprived areas (37.8%; aRR = 1.11; 95% CI = 1.06–1.16).
Women who were severely frail had much greater risks of being diagnosed after an emergency hospital admission than those who were more fit (68.6% vs 29.2%; aRR = 1.88; 95% CI = 1.78–1.99).
Those diagnosed after an emergency admission to the hospital were more likely to be diagnosed with early-stage ovarian cancer than those diagnosed in other settings (13.7% vs 39.2%).
DISCLOSURES: For full disclosures of the study authors, visit bmjoncology.bmj.com.
