Alex Thawani1, Dzinkambani Kambalame1,2, Jim Mtambo3, Patrick Mapulanga3, Vincent S Phiri2, Fanuel Lampiao4, Adamson Sinjani Muula2
Abstract
Introduction
Ovarian cancer is a leading gynecological malignancy mortality globally. Clinical outcomes in sub-Saharan Africa (SSA) are poor, largely due to late-stage presentation and limited accessing to effective treatment options. Referral pathways also delay diagnosis and compromise delivery of guideline-concordant care. A comprehensive mapping of evidence on ovarian cancer presentation and management across SSA is needed to characterize what is known, where evidence is concentrated, and where critical gaps persist.
Methods and analysis
This protocol describes a systematic scoping review of literature on ovarian cancer presentation and management in SSA. The review will be conducted in accordance with the Arksey and O’Malley methodological framework and reported using PRISMA-ScR guidance. The Population Concept Context (PCC) framework will guide eligibility and data charting (Population: individuals diagnosed with ovarian cancer, including epithelial ovarian cancer and, where specified, fallopian tube or primary peritoneal cancer; Concept: presentation from symptom onset to diagnosis and management across the care pathway; Context: SSA). We will search PubMed, Embase, Scopus, Web of Science, CINAHL, and the Cochrane Library, alongside relevant grey literature sources (organizational websites, conference proceedings, dissertations/theses). Searches will be limited to English-language evidence published between January 2000 and June 2026. Two reviewers will independently screen titles/abstracts and full texts, with disagreements resolved by consensus or a third reviewer. Data will be charted using a standardized extraction form capturing study characteristics, presentation indicators (symptoms, stage at diagnosis, delays), diagnostic/staging approaches, management modalities (surgery, systemic therapy, radiotherapy, supportive/palliative care), and barriers/facilitators. Results will be synthesized using descriptive mapping and narrative/thematic synthesis.
Ethics and dissemination
Ethics approval is not required as this review will use de-identified publicly available data. Findings will be disseminated through peer-reviewed publications, conference presentations, and stakeholder engagement to inform policy, service delivery, and research priorities for improving ovarian cancer outcomes in SSA.
Strengths and limitations of this study
This review will provide a comprehensive evidence map across the ovarian cancer care pathway in sub-Saharan Africa, drawing on both published and grey literature to characterize the scope, distribution, and nature of available evidence. Rigor and transparency will be strengthened through dual independent screening of titles/abstracts and full texts. However, restricting inclusion to English-language evidence published between 2020 and June 2026 may result in the omission of relevant studies from earlier periods or those published in other languages. In addition, no critical appraisal of the quality of the studies will be undertaken, consistent with the objectives of a scoping review to map evidence rather than evaluate study quality.
Keywords: Ovarian cancer; Sub-Saharan Africa; Diagnostic delay; Cancer management; Health systems; Scoping review