Nearly half of ovarian cancer cases are diagnosed in ER, missing critical treatment window, study finds
A startling 40% of women with ovarian cancer are only diagnosed after a sudden emergency room admission, a new study has found.
This emergency route leaves patients three times less likely to catch the disease at an early, highly curable stage compared to those diagnosed through planned doctor visits, according to the study, which was published Tuesday in the medical journal BMJ Oncology.
The findings come as a stark warning for the estimated 21,010 Americans expected to be diagnosed with ovarian cancer this year, according to the National Cancer Institute. Because major health panels recommend against routine screening for the general public due to a lack of highly accurate tests, survival relies heavily on recognizing vague warning signs.
The relentless nature of the disease was recently highlighted by tennis legend Chris Evert, who announced she would skip Wimbledon because her ovarian cancer returned.
The new study, which analyzed registry data for 28,204 women, found that emergency diagnoses skyrocketed to 68.6% among severely frail women and 44.2% for those living in economically deprived neighborhoods. Young women aged 18 to 29 also faced elevated risks at 42.7%.
Ovarian cancer progresses quietly, often leaving patients with no warning until the disease has advanced. Without an early warning sign, the cancer expands until it triggers an acute crisis, such as severe fluid buildup or a bowel obstruction, forcing an ER visit where urgent imaging scans finally unmask the disease.
"We know that patients with a BRCA mutation are more prone to getting ovarian cancer earlier in life," Dr. Areta Bojko, a board-certified obstetrician and gynecologist, told ABC News.
Early symptoms of ovarian cancer -- including mild bloating, stomach pain, or early satiety -- are easy to mistake for routine acid reflux, indigestion, or constipation.
Bojko urges women to watch for abrupt changes in any baseline patterns of bloating or cramping, and to be particularly mindful of early satiety.
"Pay attention to whether you are getting full faster," Bojko said. "If you normally eat a full burger and now you can only take two bites before feeling full, that is a warning sign."
She urges patients to advocate firmly for themselves if they note persistent changes in these patterns, noting there is "no harm in asking for imaging" like a pelvic ultrasound or a CT scan from their physician.
While catching the disease early remains difficult, women have incredibly powerful, tangible options to lower their baseline risk before the disease develops.
"Women who have used oral birth control have a 30% to 50% lower risk of ovarian cancer than women who have never used them," Bojko said.
There are other proactive treatments and surgeries that can significantly reduce risk, Bojko said, urging women to ask their doctor about options that that would be appropriate given their fertility goals and overall health.
Yonathan Daniel, M.D., is an internal medicine resident physician at NYU Langone Health and a member of the ABC News Medical Unit.
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