review · Frontiers in Oncology
Cervical cancer remains a major public health challenge across Sub-Saharan Africa, where access to early screening and clinical treatment is frequently constrained. A comprehensive systematic review and meta-analysis synthesised findings from 23 eligible studies identified across major scientific databases and grey literature to evaluate patient survival. Using a random-effects model, the analysis revealed that the pooled one-year survival rate for women diagnosed with cervical cancer in the region is 65 percent. Survival drops progressively over subsequent years, falling to 60 percent at two years, 48 percent at three years, and 42.9 percent at four years. By five years post-diagnosis, the pooled survival rate declines to 35 percent. These survival figures are considerably lower than global averages, pointing to severe and persistent difficulties in managing the disease in Sub-Saharan Africa.
Understanding cancer survival outcomes is critical for assessing healthcare performance. This evidence demonstrates that only about one in three women with cervical cancer in Sub-Saharan Africa survives five years after diagnosis. These poor outcomes underline the critical need for regional governments, healthcare providers, and international bodies to expand screening access, ensure early diagnosis, and strengthen clinical treatment pathways.
The abstract does not indicate an application pathway, as it is an epidemiological meta-analysis detailing regional patient survival rates.
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Background: Despite the availability of vaccination and early treatment, cervical cancer remains a significant public health concern globally, particularly in Sub-Saharan Africa, where access to screening and treatment is often limited. Methods: In this study, researchers conducted a survey of four international databases-Medline/PubMed, Scopus, Web of Science, and Henare-along with Google Scholar to search for gray literature. The keywords used for searching the international databases included "Uterine Cervical Neoplasms [Mesh]," "Survival OR Survival Analysis OR Survival Rate," and "Sub-Saharan countries" (including the names of specific countries). Six researchers independently screened and extracted data from the articles. All studies published in English were included without restriction and assessed for quality using the adapted Newcastle-Ottawa Scale for cohort and cross-sectional studies. The results of this systematic review were reported in accordance with the PRISMA checklist. Results: Out of the 2,180 articles initially identified, 23 were deemed eligible and reported on the survival status of patients with cervical cancer in Sub-Saharan Africa. This study assessed the multi-year survival rates (1, 2, 3, 4, and 5 years) of patients with cervical cancer. Based on the random-effects model, the overall pooled 1-year survival was 65.0% [95% confidence interval (CI), 52-78] with I² = 99.31 and p-value < 0.001. The 2-year survival rate was 60% (95% CI, 46-74) with I² = 99.12 and p-value < 0.001, the 3-year survival was 48% (95% CI, 35-62) with I² = 98.45 and p-value < 0.001, the 4-year survival was 42.9% (95% CI, 32.7-53.1) with I² = 96.80 and p-value < 0.001, and the 5-year survival was 35% (95% CI, 27-44) with I² = 98.74 and p-value < 0.001. Conclusions: This systematic review and meta-analysis found that the survival rates for patients with cervical cancer in Sub-Saharan Africa are much lower than the global averages. The results show that the 5-year survival rate can be as low as 35%, highlighting serious challenges in managing cervical cancer in this region. To address this issue, collaboration among governments, healthcare providers, and international organizations is essential to enhance the availability and quality of care. Future research should focus on developing effective early detection and treatment strategies and monitoring long-term survival outcomes.
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DOI: 10.3389/fonc.2024.1491840
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