Epidemiology of cancer-related pain in Africa: A systematic review and meta-analysis of studies from 2001 to 2024

Background: Pain is a common symptom at cancer diagnosis and often worsens with treatment and disease progression. Comprehensive evidence on its prevalence and severity in Africa remains limited. Objectives: This systematic review and meta-analysis aimed to estimate the prevalence and severity of cancer-related pain among adult cancer patients in Africa using available evidence. Methods: Google Scholar, PubMed, and the Cochrane Library were searched for articles that reported the prevalence of pain in cancer patients in African countries. The methodological quality of included studies was assessed using a quality assessment tool for prevalence studies, and the certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Pooled estimates of the prevalence and severity of cancer-related pain were calculated. Study heterogeneity was assessed using I², while sensitivity analyses were performed to test the robustness of the findings. Results: ² = 97.5%). However, the heterogeneity was substantial. Conclusion: More than three-quarters of patients suffer from cancer-related pain, with a substantial proportion experiencing moderate-to-severe levels with moderate certainty. Considerable variability exists in pain prevalence and severity across studies and regions of Africa. As a result, findings should be interpreted with caution. Improving access to analgesics may help alleviate pain and enhance quality of life for cancer patients.