Cervical cancer remains a major health challenge in Africa, where progress toward the WHO’s 90–70–90 elimination targets has been hindered by health system inequalities and gaps in prevention. Using data from the Global Burden of Disease Study 2023, this study found rising trends in cervical cancer across the African Union from 1990 to 2023. Incidence increased from 17.41 to 23.53 per 100,000, and DALYs rose from 368.58 to 430.7 per 100,000. The highest burden was seen in Southern, Central, and Eastern Africa, with women aged 40–54 being the most affected. Projections to 2038 suggest further increases in burden, with rates remaining above the WHO elimination threshold. Structural health system limitations, insufficient HPV vaccination, and low screening rates are key drivers. Urgent, region-specific interventions are needed to reverse these trends.
Background: Cervical cancer remains a leading cause of cancer-related morbidity and mortality in Africa, where progress toward WHO’s 90–70–90 elimination targets has been limited by structural health inequalities and gaps in prevention services.
Methods: We conducted a comprehensive analysis of cervical cancer burden across the African Union from 1990 to 2023, using data from the Global Burden of Disease Study 2023. Four key indicators—incidence, prevalence, mortality, and disability-adjusted life years (DALYs)—were extracted and stratified by region and age group. Estimated Annual Percentage Change (EAPC) was calculated to assess long-term trends, while age-specific and regional disparities were evaluated. Future burden was projected to 2038 using the Autoregressive Integrated Moving Average (ARIMA) model.
Results: While global cervical cancer rates have declined modestly since 1990, Africa has experienced rising trends across all indicators. From 1990 to 2023, the age-standardised incidence rate in the African Union rose from 17.41 to 23.53 per 100,000 population (EAPC = 0.67, 95% CI: 0.48–0.87), and DALYs increased from 368.58 to 430.7 per 100,000 (EAPC = 0.24, 95% CI: 0.07–0.41). Central, Southern, and Eastern Africa showed the highest burden, with Southern Africa recording the most rapid increase in incidence (EAPC = 1.54). Age-specific analysis revealed a concentrated burden among women aged 40–54, with absolute case numbers nearly doubling in this group since 1990. Projections suggest a substantial increase in incidence, prevalence, deaths and DALYs by 2038, and the gap between Africa and the global average is expected to widen further, with incidence rates remaining significantly above the WHO elimination threshold of <4/100,000.
Conclusion: Africa’s cervical cancer burden is increasing and diverging from global progress. Structural health system limitations, insufficient HPV vaccination coverage, and low screening uptake are key contributors. Urgent, region-specific interventions—integrating prevention, screening, and treatment—are essential to reverse current trends and achieve WHO elimination goals.
