Incidence and predictors of mortality among cervical cancer patients in Sub-Saharan Africa: a systematic review and meta-analysis.

Objective: To estimate the pooled incidence of mortality and identify key predictors of survival outcomes among cervical cancer patients in Sub-Saharan Africa by systematically reviewing and meta-analyzing observational studies and clinical trials published between 2000 and 2024, thereby providing evidence to guide targeted interventions and health policy improvements in the region. Data sources: PubMed, Embase, Cochrane Library, Web of Science, AJOL, CINAHL, and Google Scholar for studies published between 2000 and 2024. Study eligibility criteria: P: Patients with cervical cancer, I: Groups of variables that have a positive correlation with cervical cancer mortality, C: Types of variables that are notably linked to cervical cancer, O: individuals with cervical cancer and death rates. We included observational studies and clinical trials reporting mortality incidence and predictors among cervical cancer patients in SSA. Study appraisal and synthesis methods: Following PRISMA guidelines and registered with PROSPERO, all identified records were imported into reference Rayyan software to remove duplicates. Meta-analysis was conducted utilizing Stata 17 version statistical software. Results: From 57 studies, predominantly from South Africa, Kenya, and Nigeria. The pooled mortality incidence was 32.06% (95% CI: 29.71-34.41). Significant predictors of mortality included advanced stage at diagnosis (HR=2.6, 95% CI: 2.1-3.2), age over 65 years (HR=2.0, 95% CI: 1.5-2.6), HIV-positive status (HR=1.52, 95% CI: 1.06-2.19), treatment with radiotherapy alone (HR=1.41, 95% CI: 1.22-1.63), and anemia (HR=2.0, 95% CI: 1.5-2.5). High heterogeneity (I²=95.72%) was observed across studies. Conclusion: Approximately one-third of cervical cancer patients in SSA die from the disease, driven by identifiable predictors that highlight the need for enhanced screening, early diagnosis, and improved treatment access. Targeted interventions for high-risk groups, such as HIV-positive women and the elderly, are critical to reducing mortality in this region.