Burden, Regional Trends and Risk Factors of Breast, Cervical, Uterine, and Ovarian Cancers in Sub-Saharan Africa, 1990–2023: The Global Burden of Disease 2023

Bolarinwa, Obasanjo; Bashir, Sharmake Gaiye; Okyere, Joshua; Abdi, Yusuf Hared; Salad, Hiba Abdi; Dada, Olusegun; Yusuff, Abdulwasiu Ojo

Burden, Regional Trends and Risk Factors of Breast, Cervical, Uterine, and Ovarian Cancers in Sub-Saharan Africa, 1990–2023: The Global Burden of Disease 2023

Bolarinwa, Obasanjo ORCID: https://orcid.org/0000-0002-9208-6408, Bashir, Sharmake Gaiye, Okyere, Joshua ORCID: https://orcid.org/0000-0003-4080-7522, Abdi, Yusuf Hared ORCID: https://orcid.org/0009-0002-7224-2247, Salad, Hiba Abdi, Dada, Olusegun ORCID: https://orcid.org/0009-0005-9977-2653 and Yusuff, Abdulwasiu Ojo (2026) Burden, Regional Trends and Risk Factors of Breast, Cervical, Uterine, and Ovarian Cancers in Sub-Saharan Africa, 1990–2023: The Global Burden of Disease 2023. International Journal of Environmental Research and Public Health, 23 (4). p. 419.

Preview

Text
ijerph-23-00419-v2.pdf - Published Version
Available under License Creative Commons Attribution.
| Preview

Official URL: https://doi.org/10.3390/ijerph23040419

Abstract

Highlights: Public health relevance—How does this work relate to a public health issue? Cancers are an increasingly important driver of morbidity and premature mortality among women in sub-Saharan Africa, showing a widening non-communicable disease burden during epidemiological transition. This study maps long-term trends and regional heterogeneity in breast, cervical, uterine and ovarian cancer incidence, mortality, and disability-adjusted life years across 48 countries from 1990 to 2023 using Global Burden of Disease estimates. Public health significance—Why is this work of significance to public health? The findings show substantial and uneven growth in cancer burden across sub-Saharan Africa, with breast cancer rising sharply in absolute burden and cervical cancer remaining a dominant cause of cancer mortality in Eastern and Southern Africa. High mortality-to-incidence patterns and persistent regional inequities indicate gaps in prevention, early detection and treatment capacity, underscoring the need for targeted and region-specific cancer control responses. Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health? Expanding equitable access to HPV vaccination, organised screening and timely diagnostic and treatment services is essential, with prioritisation tailored to regional burden profiles and age-specific risk patterns. Prevention strategies should address dominant modifiable risks, including unsafe sex for cervical cancer and metabolic and lifestyle risks for breast, uterine and ovarian cancers, alongside strengthened cancer surveillance and subnational monitoring to guide resource allocation. Abstract: Background: Sub-Saharan Africa is undergoing a rapid epidemiological transition marked by a growing burden of non-communicable diseases, including breast, cervical, ovarian, and uterine cancers, which constitute major causes of morbidity and mortality among women in the region; however, comprehensive assessments of long-term trends and regional heterogeneity remain limited. This study examines the burden and temporal trends of breast, cervical, ovarian, and uterine cancers across sub-Saharan Africa from 1990 to 2023. Methods: A retrospective ecological analysis was conducted using data from the latest Global Burden of Disease 2023 study. Age-standardised incidence rates, mortality rates, and disability-adjusted life year rates were estimated for breast, cervical, ovarian, and uterine cancers across 48 sub-Saharan African countries and four sub-regions. Temporal trends were assessed from 1990 to 2023, with percentage changes calculated to characterise epidemiological transitions. Geographic variation and age-specific patterns were examined to identify high-burden settings and priority populations. Results: Between 1990 and 2023, the burden of all four cancers increased substantially across sub-Saharan Africa, with significant regional and country-level heterogeneity. Breast cancer exhibited the largest absolute burden, with incidence increasing by over 120 percent and mortality by more than 80 percent, particularly in Central and Western Africa. Cervical cancer remained the leading cause of cancer-related mortality among women in Eastern and Southern Africa, despite evidence of stabilisation or decline in selected countries. Ovarian and uterine cancers demonstrated sustained upward trends, especially in Central Africa, with high mortality-to-incidence ratios indicating late diagnosis and limited treatment access. Across all cancer types, Central and Eastern sub-Saharan Africa consistently experienced the highest disability-adjusted life year burdens. Conclusions: The burden of the selected cancers in sub-Saharan Africa has increased markedly over the past three decades, with persistent regional inequities reflecting gaps in prevention, early detection, and treatment capacity. Strengthening cancer surveillance systems, expanding equitable access to screening and vaccination programmes, and improving diagnostic and treatment infrastructure are critical to reversing current trends. These findings provide region-specific evidence to guide cancer control priorities and resource allocation across sub-Saharan Africa.