CERVICAL CANCER IN ZAMBIA: A SYSTEMATIC REVIEW OF DISEASE AND COST BURDEN
Author(s)
Linda Siachalinga, MSc1, Suzanna P. Mongan, MD, Ob-Gyn (Gyn-Onc)2, Namal N. Balasooriya, PhD3, Elisabeth N. Coyne, PhD4, Joshua Byrnes, PhD5, Hansoo Kim, BSc, MSc, PhD6.
1School of Medicine and Dentistry, Griffith University, Gold Coast, Australia, 2School of Medicine and Dentistry Griffith University, Gold Coast, Australia, 3School of Medicine and Dentistry,Griffith University, Gold Coast, Australia, 4School of Nursing and Midwifery, Griffith University,, Gold Coast, Australia, 5Univerisity of Queensland, Brisbane, Australia, 6Bond University, Robina, Australia.
1School of Medicine and Dentistry, Griffith University, Gold Coast, Australia, 2School of Medicine and Dentistry Griffith University, Gold Coast, Australia, 3School of Medicine and Dentistry,Griffith University, Gold Coast, Australia, 4School of Nursing and Midwifery, Griffith University,, Gold Coast, Australia, 5Univerisity of Queensland, Brisbane, Australia, 6Bond University, Robina, Australia.
OBJECTIVES: To review the disease and cost burden of cervical cancer in Zambia to support future health policy.
METHODS: PubMed, Embase and Google Scholar were searched from database inception to 14th August 2025. Search terms included cervical cancer, epidemiology, cost and Zambia while applying appropriate Boolean operators. This study was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis.
RESULTS: Twenty-eight studies met inclusion eligibility criteria. Of the included studies, 24 reported disease burden (24 descriptive studies and one non-RCT) and four cost burden studies. The overall quality of the studies included was good. Cervical cancer prevalence ranged from 1% -6%, pooled estimates [2% (95% CI: 1,4)]. The age standardised incidence/100, 000 women ranged from 17.2 -186 with case fatality rate of 7.3%. HIV infection, age, high-risk human papilloma virus (hrHPV), and multiple sexual partners were identified as predictors for cervical cancer. The prevalence of hrHPV ranged from 34% -94%, highest among women diagnosed with cervical intraepithelial neoplasia 2+ and cervical cancer. The prevalence of HPV 16/18 ranged from 7.7% -51.6%. Zambia faces a substantial funding gap in cervical cancer prevention, with only 36% of required resources met, however integrated screening is highly cost-effective, with costs of $106 -$607/ disability adjusted life years averted, and HPV vaccination is cost-saving at around I$5/vaccinated girl and remains cost-effective up to I$50.
CONCLUSIONS: The review identified a high disease burden and limited evidence on cost burden, underscoring the need to implement preventive interventions, and further economic evaluation of existing programmes.
METHODS: PubMed, Embase and Google Scholar were searched from database inception to 14th August 2025. Search terms included cervical cancer, epidemiology, cost and Zambia while applying appropriate Boolean operators. This study was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis.
RESULTS: Twenty-eight studies met inclusion eligibility criteria. Of the included studies, 24 reported disease burden (24 descriptive studies and one non-RCT) and four cost burden studies. The overall quality of the studies included was good. Cervical cancer prevalence ranged from 1% -6%, pooled estimates [2% (95% CI: 1,4)]. The age standardised incidence/100, 000 women ranged from 17.2 -186 with case fatality rate of 7.3%. HIV infection, age, high-risk human papilloma virus (hrHPV), and multiple sexual partners were identified as predictors for cervical cancer. The prevalence of hrHPV ranged from 34% -94%, highest among women diagnosed with cervical intraepithelial neoplasia 2+ and cervical cancer. The prevalence of HPV 16/18 ranged from 7.7% -51.6%. Zambia faces a substantial funding gap in cervical cancer prevention, with only 36% of required resources met, however integrated screening is highly cost-effective, with costs of $106 -$607/ disability adjusted life years averted, and HPV vaccination is cost-saving at around I$5/vaccinated girl and remains cost-effective up to I$50.
CONCLUSIONS: The review identified a high disease burden and limited evidence on cost burden, underscoring the need to implement preventive interventions, and further economic evaluation of existing programmes.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EPH7
Topic
Epidemiology & Public Health
Disease
SDC: Oncology, SDC: Reproductive & Sexual Health