Full length article| Volume 266, P145-149, November 2021

Download started.


Evaluation of women referred to the two-week wait gynaecology clinic with suspected ovarian cancer

Published:October 01, 2021DOI:



      Ovarian cancer is the leading cause of death from gynaecological cancer in the UK, making early diagnosis key. The two-week wait pathway aims to facilitate rapid referrals from primary to secondary care for suspected cancer thus increasing rates of early diagnosis. The objective of this study was to evaluate referrals made via the two-week wait pathway for suspected ovarian cancer.

      Study Design

      A retrospective analysis of 215 women referred on the two-week wait pathway to a tertiary centre in the United Kingdom with suspected ovarian cancer in 2018.


      Only 16% of women referred were subsequently diagnosed with gynaecological malignancy. Of those diagnosed with ovarian cancer, 78% had late stage disease at diagnosis. Pre-menopausal women made up 29% of those referred, but only 6% of those diagnosed with cancer.


      Despite its goal of increasing early stage diagnosis of cancer, the majority of women referred via the two-week wait pathway do not have cancer, and the majority of those who do are referred with late stage disease. These results highlight the need for an effective screening programme for ovarian cancer.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      1. Cancer Research UK. Ovarian Cancer Statistics. [Cancer Research UK web site]. Accessed December 2019.

        • Fagotti A.
        • Ferrandina M.G.
        • Vizzielli G.
        • Pasciuto T.
        • Fanfani F.
        • Gallotta V.
        • et al.
        Randomized trial of primary debulking surgery versus neoadjuvant chemotherapy for advanced epithelial ovarian cancer (SCORPION-NCT01461850).
        Int J Gynecol Cancer. 2020; 30: 1657-1664
      2. NHS England. Achieving World-Class Cancer outcomes: Taking the strategy forward [NHS England web site]. 2016. Accessed December 2019.

      3. National Institute for Health and Care Excellence (2015) Suspected cancer: recognition and referral NICE guideline [NG12] . Available at: . Accessed May 2021.

        • Network N.C.I.
        Routes to Diagnosis 2006–2013 workbook (a).
        NCIN, London2015
        • Allgar A.L.
        • Neal R.D.
        • Ali N.
        • et al.
        Variation in ‘fast-track’ referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites.
        Br J Gen Pract. 2006; 56: 355-362
        • Zhou Y.
        • Mendonca S.C.
        • Abel G.A.
        • Hamilton W.
        • Walter F.M.
        • Johnson S.
        • et al.
        Variation in 'fast-track' referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites.
        Br J Cancer. 2018; 118: 24-31
        • Chase D.M.
        • Harrow B.
        • Perhanidis J.
        • Monk B.J.
        Gastrointestinal symptoms and diagnosis preceding ovarian cancer diagnosis: Delays in diagnosis and resulting effects on treatment allocation.
        J Clin Oncol. 2019; 37 (e18195-e18195)
        • Prat J.
        FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum.
        Int J Gynaecol Obstet. 2014; 124: 1-5
      4. National Cancer Intelligence Network and Cancer Research UK. Routes to diagnosis of cancer by stage, 2012-2013 workbook. London: NCIN; 2016.

      5. Target Ovarian Cancer. Data Briefing on Ovarian Cancer. [Target Ovarian Cancer web site]. 21 December 2018. Accessed December 2019.

        • Landy R.
        • Pesola F.
        • Castañón A.
        • Sasieni P.
        Impact of cervical screening on cervical cancer mortality: estimation using stage-specific results from a nested case-control study.
        Br J Cancer. 2016; 115: 1140-1146
      6. Jacobs IJ, Menon U, Ryan A, et al. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial [published correction appears in Lancet. 2016 Mar 5;387(10022):944] [published correction appears in Lancet. 2016 Mar 5;387(10022):944]. Lancet. 2016;387(10022):945–956.

        • Montagnana M.
        • Benati M.
        • Danese E.
        Circulating biomarkers in epithelial ovarian cancer diagnosis: from present to future perspective.
        Ann Transl Med. 2017; 5 (276-276)
      7. Department of Health. The NHS cancer plan 2000. Archived. Accessed May 2021.