Tadele Emagneneh ^1,2* Chalie Mulugeta ¹ Betelhem Ejigu ¹ Abebaw Alamrew ¹ Aynalem Y. Hiwot ¹ Sefineh F. Feleke ¹

• ¹ Woldia University, Woldiya, Ethiopia
• ² Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia

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 surveyed 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. Results: Out of the 2,180 articles identified, 23 were deemed eligible and reported on the survival status of cervical cancer patients in Sub-Saharan Africa. This study assessed the multi-year survival rates (1, 2, 3, 4, and 5 years) of cervical cancer patients. Based on the random-effects model, the overall pooled one-year survival was 65.0% (95% Confidence Interval [CI], 52–78) with I² = 99.31 and p-value < 0.001. The two-year survival rate was 60% (95% CI, 46–74) with I² = 99.12 and p-value < 0.001, the three-year survival was 48% (95% CI, 35–62) with I² = 98.45 and p-value < 0.001, the four-year survival was 42.9% (95% CI, 32.7–53.1) with I² = 96.80 and p-value < 0.001, and the five-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 cervical cancer patients in Sub-Saharan Africa are much lower than the global averages. The results show that the five-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.