Do you know Cervical cancer continues to pose a heavy burden across the African continent. It is a malignant tumour arising from the cells of the cervix (the lower part of the uterus that connects to the vagina), it is nearly always caused by persistent infection with high-risk strains of the Human papillomavirus (HPV). According to the World Health Organization (WHO), globally there were approximately 660,000 new cervical cancer cases and around 350,000 deaths in 2022 — and the highest incidence and mortality occur in low- and middle-income countries.
In Africa, the situation is particularly acute. Almost all of the 20 countries worldwide with the greatest burden of cervical cancer were in the African region in 2018. The incidence and mortality rates are far higher than in developed settings; for example, the WHO’s African region estimates about 34 cases per 100,000 women and 23 deaths per 100,000 women annually (good to know some cases are undocumented) — compared with roughly 7 and 3 respectively per 100,000 women in North America.
Epidemiology and Key Risk Factors
HPV strains 16 and 18 are responsible for approximately 70 % of cervical cancer cases worldwide. Women living with HIV have markedly elevated risk: the WHO notes that women with HIV are about six times more likely to develop cervical cancer compared to their HIV-negative counterparts.
Other key risk factors in the African context include early onset of sexual activity, multiple sexual partners, exposure to other sexually transmitted infections, and smoking. The late stage at presentation is a recurring issue: many women are only diagnosed when the disease has advanced, limiting treatment options.
From an epidemiologic perspective, the African region accounted for 23 % of global cervical cancer mortality in 2022, with the share expected to increase to 30 % by 2030 unless the current trend is reversed.
Prevention: Vaccination and Lifestyle
HPV Vaccination
Primary prevention of cervical cancer revolves around vaccination against HPV. The WHO recommends that adolescents (principally girls aged 9-14 years) receive two doses of HPV vaccine (or a single-dose schedule where accepted) before exposure to HPV infection. In the African region, however, only 28 of 47 countries had introduced HPV vaccination programmes into their national immunisation schedule, and in 2022 the coverage of the first dose was only about 33 %.
Several countries are now shifting to a single-dose schedule in line with updated WHO guidance and to optimise resource use and implementation feasibility.
Other Preventive Measures
Beyond vaccination, measures such as age-appropriate sexual and reproductive health education, male circumcision (which may reduce HPV transmission), smoking cessation, use of condoms and broader efforts to reduce inequities in access to healthcare are all integral.
Early Detection and Screening
Screening (secondary prevention) aims to detect precancerous lesions or early-stage cancer in asymptomatic women, so that treatment can prevent progression or improve outcomes. According to WHO guidance for the African region, screening is recommended for women aged 25-49 years. Acceptable screening methods in low-resource settings include HPV-DNA testing, visual inspection with acetic acid (VIA), and the Pap smear (cytology) where feasible.
In practice, many African countries still rely on lower-performance screening methods, and coverage is low. For instance, a systematic review found that screening uptake is very limited in sub-Saharan Africa, with major structural, cultural and socioeconomic barriers to access.
Importantly, screening with timely follow-up and treatment of precancerous lesions has the potential to prevent up to 80 % of cervical cancer cases if implemented effectively.
Diagnosis, Treatment and Prognosis
When cervical cancer is diagnosed early and treated appropriately, the prognosis is generally favourable: five-year survival in settings with good access can exceed 80%. However, in Africa, presentation tends to be at later stages, diagnostic and treatment infrastructure is limited, and guideline-adherent treatment is often unavailable. One multi-country study of nine population-based registries across sub-Saharan Africa found only 5.2 % of women received guideline-adherent curative therapy.
Treatment of invasive cervical cancer typically includes surgery (such as hysterectomy) for early stages, and combinations of radiotherapy and chemotherapy for more advanced disease. Palliative care should be integrated for women with incurable disease.
The major barriers in many African countries include limited availability of radiotherapy machines, lack of trained oncology staff, poor referral systems, and high loss-to-follow-up rates.
Moving forward, people in Africa can take practical steps to protect themselves and their communities from cervical cancer. The first step is awareness: women aged 25 to 49 should know that regular screening can detect precancerous changes before they become life-threatening. Those eligible for the HPV vaccine—especially girls aged 9 to 14—should get vaccinated as early as possible.
Women can locate screening centers by visiting local health clinics, government hospitals, or outreach programs run by ministries of health and organizations such as WHO, UNFPA, or Africa CDC. Many countries, including Rwanda, Kenya, Nigeria, and South Africa, now offer free or low-cost screening services at reproductive health clinics or during community health drives.
Men also play a role by supporting their partners, helping with transport, and encouraging vaccination for daughters. Health workers can raise community awareness, dispel myths, and link patients to nearby diagnostic and treatment facilities.
Ultimately, cervical cancer prevention starts with action—getting vaccinated, screened, and spreading the word so every woman can access life-saving care close to home.
FAQ
Q 1: At what age should women in African settings ideally be screened for cervical cancer?
Screening for women aged approximately 25-49 years is recommended in many African settings, though national guidelines may vary.
Q 2: What screening methods are feasible in low-resource settings?
Feasible methods include visual inspection with acetic acid (VIA), Pap cytology (where infrastructure exists) and HPV-DNA testing. VIA allows immediate results and may support a “screen-and-treat” model.
Q 3: Is treatment available for precancerous lesions?
Yes — once lesions are identified, treatment options include cryotherapy, loop electrosurgical excision procedure (LEEP) and conisation, which prevent progression to invasive cancer.
Q 4: How does HIV affect the risk of cervical cancer?
Women living with HIV are at markedly increased risk of cervical cancer and often experience more rapid progression from precancer to invasive disease; therefore screening and treatment need to be prioritised in this population.
Q 5: What are the global targets for cervical cancer elimination?
Under the WHO Global Strategy, by 2030 countries aim to reach: 90 % HPV vaccination coverage of girls by age 15; 70 % screening coverage of women by age 35 and again by age 45; and 90 % of women with cervical disease receiving treatment.