Key findings from the National Ovarian Cancer Audit 2026
The third National Ovarian Cancer Audit (NOCA) report, the State of the Nation Report 2026, takes an in-depth look at how ovarian cancer care was delivered to women in England in 2022-2023 and in Wales in 2022-2024. The audit provides insights into treatment patterns, survival rates, and areas where improvements are still needed.
Crucially, as this is the third report, we can now see if improvements are happening.
What is the National Ovarian Cancer Audit?
The NOCA report looks at how well women with ovarian cancer are being cared for across England and Wales. It tracks things like:
- How and when patients are diagnosed
- What treatments they receive, including surgery and chemotherapy specifically
- How many women survive at least one and two years after diagnosis.
This is the third State of the Nation report, and a new report will be published each year. The goal is to find out where care can be improved to give women the best chance of survival and track changes year-on-year.
Ovarian Cancer Action's role in the audit
Ovarian Cancer Action campaigned for nearly a decade to secure this audit, working alongside supporters, Target Ovarian Cancer, and the British Gynaecological Cancer Society to push the government into funding a national picture of ovarian cancer care. Read more about how we made the National Ovarian Cancer Audit happen.
Key findings from the report
Emergency Diagnosis
An Emergency Diagnosis is when a patient had an emergency admission within 28 days before their diagnosis.
- England: 40% of women with ovarian cancer had an emergency diagnosis.
- Wales: 43% of women with ovarian cancer had an emergency diagnosis.
What this means: Women diagnosed through emergencies are four times more likely to die within two months than those diagnosed through their GP, because their symptoms have become very severe, indicating that the cancer has spread. This highlights the ongoing need for better symptom awareness and quicker access to healthcare to ensure the earliest diagnosis possible.
The audit also looked at what happens next for these women with an emergency diagnosis:
- England: 60% went on to receive any treatment (surgery and/or chemotherapy) within three months.
- Wales: 70% of women went on to receive treatment within three months.
What this means: Four out of ten women in England, and three out of ten in Wales, who have an emergency diagnosis do not have any treatment. This has been raised as a major concern, and a nationwide Quality Improvement Initiative was launched in November 2025 to help improve treatment rates for these women, and is now working with clinical teams across the country to gather and share examples of best practice.
Treatment gaps
- England: 27% of women with advanced ovarian cancer (stage 2-4, or unstaged) did not have any treatment (surgery or chemotherapy) recorded.
- Wales: Around 24% of women faced the same treatment gap.
What this means: Not all women are receiving the necessary treatment, which severely impacts survival rates. Most worryingly this varies a lot by geography. In some Centres this number is much lower, with only 12% not receiving any treatment, but this rises to an alarming 40% of patients not receiving any treatment in the worst performing Centre. Urgent action is needed to understand why some women are not receiving any treatment.
Receipt of surgery
For the first time, the audit has broken down treatment into surgery and chemotherapy separately.
- England: 51% of women with advanced ovarian cancer had any surgery recorded within nine months of diagnosis.
- Wales: 48% of women had any surgery recorded.
What this means: Only around half of women with advanced ovarian cancer are having surgery. This is extremely concerning, as surgery is a crucial part of the treatment pathway. There is an alarming postcode lottery, where the number of women not receiving surgery ranges from 34% to 66% around the country.
Receipt of chemotherapy
- England: 65% of women with advanced ovarian cancer had any chemotherapy recorded within nine months of diagnosis.
- Wales: 73% of women had any chemotherapy recorded.
What this means: Chemotherapy rates are slightly higher than surgery rates, but there is still considerable variation between hospitals, from 53% to 81%.
One-year survival rates
- England: 70% of women diagnosed with ovarian cancer survived at least one year after diagnosis.
- Wales: 74% of women survived at least one year after diagnosis.
What this means: The UK continues to lag behind countries like Australia and Norway, where one-year survival rates are higher. This indicates a continued need for improvements in care. There is still a significant postcode lottery in survival rates, from 59% to 82% across the country.
Two-year survival rates
- England: 58% of women diagnosed with ovarian cancer survived at least two years after diagnosis.
- Wales: 68% of women survived at least two years after diagnosis.
What this means: Just under six in ten women in England, and two in three in Wales, are still alive two years on from their diagnosis. NOCA has confirmed that considerable variation remains between hospitals even once differences between patients are taken into account.
What will Ovarian Cancer Action do with these findings?
Over the coming months, we will be reviewing these findings in more detail. We will use them to make sure our programmes to make care equal across the UK are targeted in the right places.
We will also use them to campaign for more urgent action to eradicate the postcode lottery.
Frequently asked questions
What is the National Ovarian Cancer Audit (NOCA)?
NOCA is a comprehensive audit of the care received by women diagnosed with ovarian cancer in England and Wales. The audit aims to track treatment patterns, survival rates, and identify areas for improvement in ovarian cancer care. The 2026 report focuses on women diagnosed in 2022-2023 (England) and 2022-2024 (Wales).
Why are emergency admissions a concern for ovarian cancer?
Around 40% of women with ovarian cancer in England and Wales are diagnosed after an emergency admission. This often means the cancer is more advanced, leading to poorer outcomes. Women diagnosed this way are four times more likely to die within two months compared to those diagnosed through planned referrals. This year's audit found that survival differences between these two groups remain stark even months after diagnosis, and that a large proportion of women admitted as an emergency don't go on to receive treatment within three months.
What are the main treatments for ovarian cancer?
The main treatments include surgery and chemotherapy. This year, for the first time, the audit reported on these separately: around half of women with advanced ovarian cancer in England and Wales had surgery, while around two-thirds to three-quarters had chemotherapy. Overall, around a quarter of women did not have any treatment recorded.
How does ovarian cancer survival in the UK compare to other countries?
70% of women in England and 74% in Wales survived at least one year after diagnosis, and 58% and 68% respectively survived at least two years. Survival rates still lag behind other countries like Australia and Norway. This suggests there is significant room to improve the quality of ovarian cancer care in the UK.
How can I help raise awareness about ovarian cancer?
You can help by sharing information about ovarian cancer symptoms, supporting early diagnosis campaigns, and getting involved in fundraising activities. Educating yourself and others about the signs of ovarian cancer could help save lives.
What are the symptoms of ovarian cancer?
Common symptoms include persistent bloating, feeling full quickly when eating, stomach or pelvic pain, and needing to urinate more often or urgently. If these symptoms persist, it's important to see a doctor.