Cervical cancer in sub-Saharan Africa: an urgent call for improving accessibility and use of preventive services

Abstract

Sub-Saharan Africa has the highest rates of cervical cancer in the world, largely attributed to low cervical cancer screening coverage. Cervical cancer is the most common cause of death among women in 21 of the 48 countries in sub-Saharan Africa. Close to 100% of all cases of cervical cancer are attributable to Human papillomavirus (HPV). HPV types 16 and 18 cause at least 70% of all cervical cancers globally, while types 31, 33, 45, 52, and 58 cause a further 20% of the cases. Women living with HIV are six times more likely to develop cervical cancer than those without HIV. Considering that sub-Saharan Africa carries the greatest burden of cervical cancer, ways to increase accessibility and use of preventive services are urgently required. With this review, we discuss the preventive measures required to reduce the burden of cervical cancer in sub-Saharan Africa, the challenges to improving accessibility and use of the preventive services, and the recommendations to address these challenges.

Human papillomavirus spectrum of HPV-infected women in Nigeria: an analysis by next-generation sequencing and type-specific PCR

“…Human papillomavirus is an infectious and primarily sexually transmitted virus and the leading cause of cervical cancer worldwide [ 20 ]. Cervical cancer is a burden most countries in the sub-Saharan Africa and Nigeria is no exception with 763,000 deaths reported in 2019 [ 5 , 21 ]. HPV vaccination status of women in Nigeria remains unknown.…”

“…Cervical cancer accounts for the second most frequent cause of cancer-related death globally. In developing countries, cervical cancer cases are women's leading cause of cancer-related deaths [ 5 ]. There were 34.8 new cases and 22.5 deaths per 100,000 women from cervical cancer [ 6 ].…”

“…In Nigeria, cervical cancer is currently the second most common cancer in women, with about 12,075 new cases diagnosed annually and 7968 deaths [ 7 ]. Sub-Saharan Africa has the highest rates of cervical cancer in the world, and it is the most common cause of death among women in 21 of the 48 countries in sub-Saharan Africa [ 5 ].…”

“…The HPV type prevalence varies between populations, as it can be country/region specific [ 9 ]. Although HPV 6, 11, 16, and 18 are generally believed to be the most common HPV types worldwide [ 5 – 7 ], however, recent data show otherwise. For example, high-risk HPV35 is the most prevalent, while HPV53 and HPV66 are the most prevalent low-risk types in Zimbabwe [ 10 – 13 ].…”

Network modeling suggests HIV infection phenocopies PI3K-AKT pathway mutations to enhance HPV-associated cervical cancer

“…In 2020, over 300 000 cervical cancer deaths were reported, out of which approximately 90% were from Low-and-Middle-Income Countries (LMICs). 1 Although cervical cancer is preventable through HPV vaccination as well as screening and treatment of pre-cancerous lesions, 2 it is disproportionately higher in LMICs due to low coverage of preventative services, inadequate treatment of pre-cancerous lesions 2,3 and late-stage detection. 4 Thus, effective screening, early detection and treatment strategies are crucial to ending the cervical cancer menace.…”