Determinants and outcomes of ovarian cancer diagnosis following an emergency presentation: a systematic review

Georgia Zachou; Swetha Rongali; Rui Wu; Jan van der Meulen; Ipek Gurol-Urganci; Andrew Hutchings; Agnieszka Michael; Sudha Sundar

doi:10.1016/j.ijgc.2026.104487

Determinants and outcomes of ovarian cancer diagnosis following an emergency presentation: a systematic review

Georgia Zachou
, Swetha Rongali
, Rui Wu
, Jan van der Meulen
, Ipek Gurol-Urganci
, Andrew Hutchings
, Agnieszka Michael
, Sudha Sundar^*

^*Corresponding author for this work

Cancer and Genomic Sciences

Research output: Contribution to journal › Review article › peer-review

Abstract

OBJECTIVE: This study aimed to identify the clinical and sociodemographic risk factors and compare cancer stage, treatment, and survival outcomes associated with ovarian cancer diagnosed following an emergency presentation versus other routes.

METHODS: A systematic search of Embase and MEDLINE was conducted from January 2000 to August 2025, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (PROSPERO: CRD420251111636). Studies were included if they examined risk factors associated with ovarian cancer diagnosis following an emergency presentation. Studies were also included if they compared treatment or survival outcomes between those diagnosed after an emergency presentation and those diagnosed via other routes. The quality of the studies was assessed using the Newcastle-Ottawa scale.

RESULTS: Of the 3499 studies identified, 12 met the inclusion criteria and included a total of 127,395 women. All of the studies were conducted in high-income countries. Older age and socioeconomic deprivation were the most common determinants of an ovarian cancer diagnosis following an emergency presentation, although most studies did not adjust for key confounders. This diagnostic route was associated with advanced tumor stage, lower rates of treatment, shorter intervals between diagnosis and treatment initiation, and poorer survival outcomes. While the included studies were at low risk of bias, substantial heterogeneity made cross-study comparison challenging, especially as contradictory findings between larger population-based studies and single-center studies were noted.

CONCLUSIONS: Women diagnosed with ovarian cancer following an emergency admission have a poor prognosis in many high-income countries. Urgent concerted action is needed to both decrease the number of women diagnosed through this diagnostic pathway and increase their treatment rates to improve survival outcomes.

Original language	English
Article number	104487
Number of pages	11
Journal	International Journal of Gynecological Cancer
Early online date	19 Jan 2026
DOIs	https://doi.org/10.1016/j.ijgc.2026.104487
Publication status	E-pub ahead of print - 19 Jan 2026

Bibliographical note

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Ovarian Cancer
Emergency Presentation
Risk Factors
Treatment
Survival

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ZachouG2026DeterminantsFinal published version, 940 KBLicence: Creative Commons: Attribution (CC BY)

Cite this

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title = "Determinants and outcomes of ovarian cancer diagnosis following an emergency presentation: a systematic review",

abstract = "OBJECTIVE: This study aimed to identify the clinical and sociodemographic risk factors and compare cancer stage, treatment, and survival outcomes associated with ovarian cancer diagnosed following an emergency presentation versus other routes.METHODS: A systematic search of Embase and MEDLINE was conducted from January 2000 to August 2025, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (PROSPERO: CRD420251111636). Studies were included if they examined risk factors associated with ovarian cancer diagnosis following an emergency presentation. Studies were also included if they compared treatment or survival outcomes between those diagnosed after an emergency presentation and those diagnosed via other routes. The quality of the studies was assessed using the Newcastle-Ottawa scale.RESULTS: Of the 3499 studies identified, 12 met the inclusion criteria and included a total of 127,395 women. All of the studies were conducted in high-income countries. Older age and socioeconomic deprivation were the most common determinants of an ovarian cancer diagnosis following an emergency presentation, although most studies did not adjust for key confounders. This diagnostic route was associated with advanced tumor stage, lower rates of treatment, shorter intervals between diagnosis and treatment initiation, and poorer survival outcomes. While the included studies were at low risk of bias, substantial heterogeneity made cross-study comparison challenging, especially as contradictory findings between larger population-based studies and single-center studies were noted.CONCLUSIONS: Women diagnosed with ovarian cancer following an emergency admission have a poor prognosis in many high-income countries. Urgent concerted action is needed to both decrease the number of women diagnosed through this diagnostic pathway and increase their treatment rates to improve survival outcomes.",

keywords = "Ovarian Cancer, Emergency Presentation, Risk Factors, Treatment, Survival",

author = "Georgia Zachou and Swetha Rongali and Rui Wu and \{van der Meulen\}, Jan and Ipek Gurol-Urganci and Andrew Hutchings and Agnieszka Michael and Sudha Sundar",

note = "Publisher Copyright: {\textcopyright} 2026 The Author(s). Published by Elsevier Inc. on behalf of European Society of Gynaecological Oncology and the International Gynecologic Cancer Society.",

year = "2026",

month = jan,

day = "19",

doi = "10.1016/j.ijgc.2026.104487",

language = "English",

journal = "International Journal of Gynecological Cancer",

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TY - JOUR

T1 - Determinants and outcomes of ovarian cancer diagnosis following an emergency presentation

T2 - a systematic review

AU - Zachou, Georgia

AU - Rongali, Swetha

AU - Wu, Rui

AU - van der Meulen, Jan

AU - Gurol-Urganci, Ipek

AU - Hutchings, Andrew

AU - Michael, Agnieszka

AU - Sundar, Sudha

PY - 2026/1/19

Y1 - 2026/1/19

N2 - OBJECTIVE: This study aimed to identify the clinical and sociodemographic risk factors and compare cancer stage, treatment, and survival outcomes associated with ovarian cancer diagnosed following an emergency presentation versus other routes.METHODS: A systematic search of Embase and MEDLINE was conducted from January 2000 to August 2025, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (PROSPERO: CRD420251111636). Studies were included if they examined risk factors associated with ovarian cancer diagnosis following an emergency presentation. Studies were also included if they compared treatment or survival outcomes between those diagnosed after an emergency presentation and those diagnosed via other routes. The quality of the studies was assessed using the Newcastle-Ottawa scale.RESULTS: Of the 3499 studies identified, 12 met the inclusion criteria and included a total of 127,395 women. All of the studies were conducted in high-income countries. Older age and socioeconomic deprivation were the most common determinants of an ovarian cancer diagnosis following an emergency presentation, although most studies did not adjust for key confounders. This diagnostic route was associated with advanced tumor stage, lower rates of treatment, shorter intervals between diagnosis and treatment initiation, and poorer survival outcomes. While the included studies were at low risk of bias, substantial heterogeneity made cross-study comparison challenging, especially as contradictory findings between larger population-based studies and single-center studies were noted.CONCLUSIONS: Women diagnosed with ovarian cancer following an emergency admission have a poor prognosis in many high-income countries. Urgent concerted action is needed to both decrease the number of women diagnosed through this diagnostic pathway and increase their treatment rates to improve survival outcomes.

AB - OBJECTIVE: This study aimed to identify the clinical and sociodemographic risk factors and compare cancer stage, treatment, and survival outcomes associated with ovarian cancer diagnosed following an emergency presentation versus other routes.METHODS: A systematic search of Embase and MEDLINE was conducted from January 2000 to August 2025, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (PROSPERO: CRD420251111636). Studies were included if they examined risk factors associated with ovarian cancer diagnosis following an emergency presentation. Studies were also included if they compared treatment or survival outcomes between those diagnosed after an emergency presentation and those diagnosed via other routes. The quality of the studies was assessed using the Newcastle-Ottawa scale.RESULTS: Of the 3499 studies identified, 12 met the inclusion criteria and included a total of 127,395 women. All of the studies were conducted in high-income countries. Older age and socioeconomic deprivation were the most common determinants of an ovarian cancer diagnosis following an emergency presentation, although most studies did not adjust for key confounders. This diagnostic route was associated with advanced tumor stage, lower rates of treatment, shorter intervals between diagnosis and treatment initiation, and poorer survival outcomes. While the included studies were at low risk of bias, substantial heterogeneity made cross-study comparison challenging, especially as contradictory findings between larger population-based studies and single-center studies were noted.CONCLUSIONS: Women diagnosed with ovarian cancer following an emergency admission have a poor prognosis in many high-income countries. Urgent concerted action is needed to both decrease the number of women diagnosed through this diagnostic pathway and increase their treatment rates to improve survival outcomes.

KW - Ovarian Cancer

KW - Emergency Presentation

KW - Risk Factors

KW - Treatment

KW - Survival

U2 - 10.1016/j.ijgc.2026.104487

DO - 10.1016/j.ijgc.2026.104487

M3 - Review article

C2 - 41680020

SN - 1525-1438

JO - International Journal of Gynecological Cancer

JF - International Journal of Gynecological Cancer

M1 - 104487

ER -

Determinants and outcomes of ovarian cancer diagnosis following an emergency presentation: a systematic review

Abstract

Bibliographical note

UN SDGs

Keywords

Access to Document

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Cite this