{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:06:30Z","timestamp":1789693590566,"version":"4.0.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":79,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","award":["SK24-00569"],"award-info":[{"award-number":["SK24-00569"]}],"id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>More advanced stages at diagnosis and lower survival rates are seen in women diagnosed with cancer during pregnancy compared to non-pregnant women with similar cancers. This study aims to investigate diagnostic and treatment delays, cancer stage, and survival in Danish pregnant cancer patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients from the Danish cancer in pregnancy database were included. Cancer diagnosis, treatment, and obstetrical data were collected from the database. Time to treatment was compared to national cancer patient pathways. Cancer stages at diagnosis were compared to epidemiological studies identified through a systematic literature search. Survival was compared to data from NORDCAN, a Nordic cancer statistics database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 74 patients diagnosed with cancer in pregnancy. The median total delay was 43.5\u00a0days (IQR 27.75\u201394.75) with a patient delay of three days (IQR 0\u201331), a diagnostic delay of 15\u00a0days (IQR 8\u201335), and a treatment delay of 9.5\u00a0days (IQR 0\u201319). Time from cancer suspicion to start of treatment fell within recommended national cancer patient pathway intervals in 80.0% of cases. Breast cancer and melanoma in pregnancy tended to have more advanced stages at diagnosis compared to non-pregnant patients. The 1- and 5-year mortality rates were 5.4% and 17.6%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that pregnant cancer patients presented with advanced stages at diagnosis and lower survival rates compared to non-pregnant patients with similar cancers. Our results indicate that the main contributor to the delay in cancer in pregnancy in Denmark is delayed suspicion of cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-026-08500-5","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T04:30:15Z","timestamp":1782880215000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic and treatment delay in women with cancer in pregnancy: a case-based study"],"prefix":"10.1007","volume":"313","author":[{"given":"Lillian Sun","family":"Liang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iben Katinka","family":"Greiber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona Aarenstrup","family":"Karlsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit Woetmann","family":"Pedersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte Bruun","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malene Kronborg","family":"Have","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke Bek","family":"Helmig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cathrine","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanett","family":"Strandbygaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lone","family":"Storgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"8500_CR1","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1634\/theoncologist.2002-0279","volume":"7","author":"NA Pavlidis","year":"2002","unstructured":"Pavlidis NA (2002) Coexistence of pregnancy and malignancy. Oncologist 7:279\u2013287. https:\/\/doi.org\/10.1634\/theoncologist.2002-0279","journal-title":"Oncologist"},{"key":"8500_CR2","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1200\/jco.2008.17.4110","volume":"27","author":"H Stensheim","year":"2009","unstructured":"Stensheim H, M\u00f8ller B, Van Dijk T, Foss\u00e5 SD (2009) Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol 27:45\u201351. https:\/\/doi.org\/10.1200\/jco.2008.17.4110","journal-title":"J Clin Oncol"},{"key":"8500_CR3","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1111\/AOGS.14677","volume":"103","author":"FE Lundberg","year":"2024","unstructured":"Lundberg FE, Stensheim H, Ullenhag GJ et al (2024) Risk factors for the increasing incidence of pregnancy-associated cancer in Sweden\u2014a population-based study. Acta Obstet Gynecol Scand 103:669\u2013683. https:\/\/doi.org\/10.1111\/AOGS.14677","journal-title":"Acta Obstet Gynecol Scand"},{"key":"8500_CR4","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1639-3","author":"J de Haan","year":"2018","unstructured":"de Haan J, Lok CAR, Schutte JS et al (2018) Cancer related maternal mortality and delay in diagnosis and treatment: a case series on 26 cases. BMC Pregnancy Childbirth. https:\/\/doi.org\/10.1186\/s12884-017-1639-3","journal-title":"BMC Pregnancy Childbirth"},{"key":"8500_CR5","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/aogs.13731","volume":"99","author":"C Maggen","year":"2020","unstructured":"Maggen C, Lok CA, Cardonick E et al (2020) Gastric cancer during pregnancy: a report on 13 cases and review of the literature with focus on chemotherapy during pregnancy. Acta Obstet Gynecol Scand 99:79\u201388. https:\/\/doi.org\/10.1111\/aogs.13731","journal-title":"Acta Obstet Gynecol Scand"},{"key":"8500_CR6","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1002\/ijc.31174","volume":"142","author":"ALV Johansson","year":"2018","unstructured":"Johansson ALV, Andersson TML, Hsieh CC et al (2018) Tumor characteristics and prognosis in women with pregnancy-associated breast cancer. Int J Cancer 142:1343\u20131354. https:\/\/doi.org\/10.1002\/ijc.31174","journal-title":"Int J Cancer"},{"key":"8500_CR7","doi-asserted-by":"publisher","first-page":"1694","DOI":"10.1111\/1471-0528.17894","volume":"131","author":"JH Heimovaara","year":"2024","unstructured":"Heimovaara JH, Huisin\u2019t Veld EA, Lok CAR et al (2024) Maternal death by cancer in pregnancy: a descriptive study of the international network on cancer, infertility and pregnancy. BJOG 131:1694\u20131704. https:\/\/doi.org\/10.1111\/1471-0528.17894","journal-title":"BJOG"},{"key":"8500_CR8","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.1007\/s00261-023-03860-x","volume":"48","author":"MV Revzin","year":"2023","unstructured":"Revzin MV, Solomon N, Langdon J et al (2023) Delayed cancer diagnosis in the pregnant patient: navigating a complex medical and ethical dilemma. Abdom Radiol 48:1599\u20131604. https:\/\/doi.org\/10.1007\/s00261-023-03860-x","journal-title":"Abdom Radiol"},{"issue":"Suppl 2","key":"8500_CR9","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.1038\/SJ.BJC.6605383","volume":"101","author":"F Olesen","year":"2009","unstructured":"Olesen F, Hansen RP, Vedsted P (2009) Delay in diagnosis: the experience in Denmark. Br J Cancer 101(Suppl 2):S5\u2013S8. https:\/\/doi.org\/10.1038\/SJ.BJC.6605383","journal-title":"Br J Cancer"},{"key":"8500_CR10","unstructured":"Sundhedsstyrelsen Historisk overblik over pakkeforl\u00f8b for kr\u00e6ft. https:\/\/www.sst.dk\/da\/Fagperson\/Sygdomme-lidelser-og-behandling\/Kraeftsygdom\/Pakkeforloeb-for-kraeft\/Historisk-overblik"},{"key":"8500_CR11","unstructured":"Sundhedsstyrelsen Pakkeforl\u00f8b for kr\u00e6ft. https:\/\/www.sst.dk\/da\/Fagperson\/Sygdomme-lidelser-og-behandling\/Kraeftsygdom\/Pakkeforloeb-for-kraeft\/Oversigt-over-kraeftpakkeforloeb"},{"key":"8500_CR12","unstructured":"Sundhedsdatastyrelsen Kr\u00e6ft. https:\/\/sundhedsdatabank.dk\/sygdomme\/kraeft"},{"key":"8500_CR13","unstructured":"NORDCAN Survival Age Specific - Trends"},{"key":"8500_CR14","doi-asserted-by":"publisher","first-page":"e517","DOI":"10.1016\/J.CLBC.2021.11.009","volume":"22","author":"JH Viuff","year":"2022","unstructured":"Viuff JH, Greiber IK, Karlsen MA et al (2022) Survival in women diagnosed with breast cancer during pregnancy. Clin Breast Cancer 22:e517\u2013e525. https:\/\/doi.org\/10.1016\/J.CLBC.2021.11.009","journal-title":"Clin Breast Cancer"},{"key":"8500_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.canep.2014.10.010","volume":"39","author":"C Bay","year":"2015","unstructured":"Bay C, Kejs AMT, Storm HH, Engholm G (2015) Incidence and survival in patients with cutaneous melanoma by morphology, anatomical site and TNM stage: a Danish population-based register study 1989\u20132011. Cancer Epidemiol 39:1\u20137. https:\/\/doi.org\/10.1016\/j.canep.2014.10.010","journal-title":"Cancer Epidemiol"},{"key":"8500_CR16","doi-asserted-by":"publisher","first-page":"8639272","DOI":"10.1155\/2016\/8639272","volume":"2016","author":"H Buvarp Dyrop","year":"2016","unstructured":"Buvarp Dyrop H, Vedsted P, R\u00e6dkj\u00e6r M et al (2016) Routes to diagnosis for suspected sarcoma: the impact of symptoms and clinical findings on the diagnostic process. Sarcoma 2016:8639272. https:\/\/doi.org\/10.1155\/2016\/8639272","journal-title":"Sarcoma"},{"key":"8500_CR17","doi-asserted-by":"publisher","first-page":"40","DOI":"10.3310\/nihropenres.13652.2","volume":"4","author":"C Hardy","year":"2025","unstructured":"The UK Breast Cancer in Pregnancy (UKBCiP) Study, Hardy C, Brand A, Jones J et al (2025) Incidence, diagnosis, management and short-term outcomes of breast cancer first diagnosed during pregnancy in the United Kingdom: A population-based descriptive study. NIHR Open Res 4:40. https:\/\/doi.org\/10.3310\/nihropenres.13652.2","journal-title":"NIHR Open Res"},{"key":"8500_CR18","unstructured":"DMG (2023) Melanom i graviditeten. https:\/\/www.dmcg.dk\/siteassets\/kliniske-retningslinjer---skabeloner-og-vejledninger\/kliniske-retningslinjer-opdelt-pa-dmcg\/dmg\/dmg_melanom-i-graviditeten_v.1.0_admgodk211223.pdf"},{"key":"8500_CR19","doi-asserted-by":"publisher","first-page":"1484","DOI":"10.1016\/s1470-2045(22)00631-3","volume":"23","author":"F Amant","year":"2022","unstructured":"Amant F, Heimovaara JH, Lok CAR, Van Calsteren K (2022) The advisory board on cancer, infertility and pregnancy: a virtual on-demand multidisciplinary tumour board. Lancet Oncol 23:1484\u20131486. https:\/\/doi.org\/10.1016\/s1470-2045(22)00631-3","journal-title":"Lancet Oncol"},{"key":"8500_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.61409\/v06230347","volume":"186","author":"L Storgaard","year":"2024","unstructured":"Storgaard L, Brix-Tange U, Colmorn LB et al (2024) New expert advice on cancer in pregnancy. Ugeskr Laeger 186:1\u20137. https:\/\/doi.org\/10.61409\/v06230347","journal-title":"Ugeskr Laeger"},{"key":"8500_CR21","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.bpobgyn.2015.10.005","volume":"33","author":"J De Haan","year":"2016","unstructured":"De Haan J, Vandecaveye V, Han SN et al (2016) Difficulties with diagnosis of malignancies in pregnancy. Best Pract Res Clin Obstet Gynaecol 33:19\u201332. https:\/\/doi.org\/10.1016\/j.bpobgyn.2015.10.005","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"8500_CR22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgc.2025.101975","volume":"35","author":"F Amant","year":"2025","unstructured":"Amant F, Planchamp F, Berveiller P et al (2025) ESGO\/INCIP guidelines for the management of patients with gynecological cancers during pregnancy. Int J Gynecol Cancer 35:101975. https:\/\/doi.org\/10.1016\/j.ijgc.2025.101975","journal-title":"Int J Gynecol Cancer"},{"key":"8500_CR23","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-11-284","author":"RP Hansen","year":"2011","unstructured":"Hansen RP, Vedsted P, Sokolowski I et al (2011) Time intervals from first symptom to treatment of cancer: a cohort study of 2212 newly diagnosed cancer patients. BMC Health Serv Res. https:\/\/doi.org\/10.1186\/1472-6963-11-284","journal-title":"BMC Health Serv Res"},{"key":"8500_CR24","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.canep.2019.01.018","volume":"59","author":"L Flytkj\u00e6r Virgilsen","year":"2019","unstructured":"Flytkj\u00e6r Virgilsen L, M\u00f8ller H, Vedsted P (2019) Cancer diagnostic delays and travel distance to health services: a nationwide cohort study in Denmark. Cancer Epidemiol 59:115\u2013122. https:\/\/doi.org\/10.1016\/j.canep.2019.01.018","journal-title":"Cancer Epidemiol"},{"key":"8500_CR25","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1080\/00016340902971482","volume":"88","author":"KM Robinson","year":"2009","unstructured":"Robinson KM, Ottesen B, Christensen KB, Krasnik A (2009) Diagnostic delay experienced among gynecological cancer patients: a nationwide survey in Denmark. Acta Obstet Gynecol Scand 88:685\u2013692. https:\/\/doi.org\/10.1080\/00016340902971482","journal-title":"Acta Obstet Gynecol Scand"},{"key":"8500_CR26","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.cdp.2008.01.001","volume":"32","author":"M Korsgaard","year":"2008","unstructured":"Korsgaard M, Pedersen L, Laurberg S (2008) Delay of diagnosis and treatment of colorectal cancer\u2014a population-based Danish study. Cancer Detect Prev 32:45\u201351. https:\/\/doi.org\/10.1016\/j.cdp.2008.01.001","journal-title":"Cancer Detect Prev"},{"key":"8500_CR27","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1097\/igc.0b013e31821d2770","volume":"21","author":"MP Vandborg","year":"2011","unstructured":"Vandborg MP, DePont CR, Kragstrup J et al (2011) Reasons for diagnostic delay in gynecological malignancies. Int J Gynecol Cancer 21:967\u2013974. https:\/\/doi.org\/10.1097\/igc.0b013e31821d2770","journal-title":"Int J Gynecol Cancer"},{"key":"8500_CR28","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1186\/s12885-015-1317-7","volume":"15","author":"H Jensen","year":"2015","unstructured":"Jensen H, T\u00f8rring ML, Olesen F et al (2015) Diagnostic intervals before and after implementation of cancer patient pathways\u2014a GP survey and registry based comparison of three cohorts of cancer patients. BMC Cancer 15:308. https:\/\/doi.org\/10.1186\/s12885-015-1317-7","journal-title":"BMC Cancer"},{"key":"8500_CR29","doi-asserted-by":"publisher","first-page":"E80","DOI":"10.3399\/bjgp19x700769","volume":"69","author":"H Jensen","year":"2019","unstructured":"Jensen H, Merrild CH, Vedsted P, M\u00f8ller H (2019) Association between GPs\u2019 suspicion of cancer and patients\u2019 usual consultation pattern in primary care: a cross-sectional study. Br J Gen Pract 69:E80\u2013E87. https:\/\/doi.org\/10.3399\/bjgp19x700769","journal-title":"Br J Gen Pract"},{"key":"8500_CR30","doi-asserted-by":"publisher","DOI":"10.1186\/S12875-021-01480-2","author":"LF Virgilsen","year":"2021","unstructured":"Virgilsen LF, Pedersen AF, Vedsted P et al (2021) Alignment between the patient\u2019s cancer worry and the GP\u2019s cancer suspicion and the association with the interval between first symptom presentation and referral: a cross-sectional study in Denmark. BMC Fam Pract. https:\/\/doi.org\/10.1186\/S12875-021-01480-2","journal-title":"BMC Fam Pract"},{"key":"8500_CR31","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1093\/fampra\/cmab025","volume":"38","author":"NH Jessen","year":"2021","unstructured":"Jessen NH, Jensen H, Helsper CW et al (2021) Cancer suspicion, referral to cancer patient pathway and primary care interval: a survey and register study exploring 10 different types of abdominal cancer. Fam Pract 38:589\u2013597. https:\/\/doi.org\/10.1093\/fampra\/cmab025","journal-title":"Fam Pract"},{"key":"8500_CR32","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1038\/s41416-024-02605-x","volume":"20","author":"MA Baxter","year":"2024","unstructured":"Baxter MA, Denholm M, Kingdon SJ et al (2024) Cancer IN pregnancy (CARING)\u2014a retrospective study of cancer diagnosed during pregnancy in the United Kingdom. Br J Cancer 20:1261\u20131268. https:\/\/doi.org\/10.1038\/s41416-024-02605-x","journal-title":"Br J Cancer"},{"key":"8500_CR33","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.ejca.2021.07.008","volume":"155","author":"ALV Johansson","year":"2021","unstructured":"Johansson ALV, Fredriksson I, Mellemkjaer L et al (2021) Cancer survival in women diagnosed with pregnancy-associated cancer: An overview using nationwide registry data in Sweden 1970-2018. Eur J Cancer 155:106\u2013115. https:\/\/doi.org\/10.1016\/j.ejca.2021.07.008","journal-title":"Eur J Cancer"}],"container-title":["Archives of Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00404-026-08500-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-026-08500-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-026-08500-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:59:17Z","timestamp":1789693157000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00404-026-08500-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8500"],"URL":"https:\/\/doi.org\/10.1007\/s00404-026-08500-5","relation":{},"ISSN":["1432-0711"],"issn-type":[{"value":"1432-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]},"assertion":[{"value":"3 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study is a part of \u2018Cancer in Pregnancy\u2019. The Danish Data Protection Agency approved the study in 2018 with approval numbers VD-2018-246 and P-2019-805. The study was conducted in accordance with the Ethical Standards of the Declaration of Helsinki. Written and oral consent were obtained from all subjects before inclusion in the study.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"270"}}