{
  "abstract": "Objectives To determine the patient characteristics associated with a diagnosis of ovarian cancer following an emergency hospital admission, and to compare cancer characteristics between those diagnosed after emergency admission and those diagnosed by other routes.Methods and analysis We conducted a national population-based study of women diagnosed with ovarian cancer in England between 2017 and 2021. Cancer registration data were linked to hospital data. Poisson regression was used to estimate adjusted risk ratios (adjRRs) that represent associations of patient characteristics with a cancer diagnosis 28 days after emergency admission.Results Among 28 204 included women, 11 377 (40.3%) were diagnosed after emergency admission. Being diagnosed after emergency admission was more common in younger (18–29 years: 42.7%, adjRR 1.36, 95% CI 1.22 to 1.52) and older women (≥80 years: 54.9%, adjRR 1.25, 1.20 to 1.31), compared with women aged 60–69 years (36.2%). Women from the most deprived quintile of neighbourhoods had higher risks of being diagnosed after emergency admission (44.2%) than those from the least deprived quintile (37.8%, adjRR 1.11, 1.06 to 1.16). Women with severe frailty had substantially increased risks of being diagnosed after emergency admission (68.6%) than those who were fit (29.2%, adjRR 1.88, 1.78 to 1.99). Of the 8438 women diagnosed after emergency admission, 1155 (13.7%) had early stage (stages 1 or 2) cancer, compared with 5442 (39.2%) of the 13 865 not diagnosed after emergency admission.Conclusions Two in five women were diagnosed after emergency admission, with even higher frequencies seen in younger and older women, frailer women, and those from deprived neighbourhoods. Women diagnosed after emergency admission were three times less likely to have early stage cancer. These UK based results are likely to be relevant for many other countries that aim to reduce the number of women diagnosed with symptoms so severe that emergency admission is necessary.",
  "authors": [
    {
      "affiliations": [
        "Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK",
        "Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"
      ],
      "name": "Georgia Zachou"
    },
    {
      "affiliations": [
        "Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK",
        "School of Biosciences, University of Surrey, Guildford, UK"
      ],
      "name": "Rui Wu"
    },
    {
      "affiliations": [
        "Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK",
        "Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK"
      ],
      "name": "Andrew Hutchings"
    },
    {
      "affiliations": [
        "Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Jan van der Meulen"
    },
    {
      "affiliations": [
        "Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK"
      ],
      "name": "Ipek Gurol-Urganci"
    },
    {
      "affiliations": [
        "School of Biosciences, University of Surrey, Guildford, UK",
        "Royal Surrey Cancer Centre, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK"
      ],
      "name": "Agnieszka Michael"
    },
    {
      "affiliations": [
        "Department of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK",
        "City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK"
      ],
      "name": "Sudha Sundar"
    }
  ],
  "title": "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",
  "uid": "d9f39bf1-ae97-53c8-ba7a-29734aec579b"
}