Diverging Cervical Cancer Burden in Africa in the Context of WHO's Elimination Strategy: Insights From GBD 2023

ABSTRACT Cervical cancer remains a leading cause of cancer‐related morbidity and mortality in Africa, where progress toward WHO's 90–70–90 elimination targets has been limited by structural health inequalities and gaps in prevention services. We conducted a comprehensive analysis of cervical cancer burden across the African Union from 1990 to 2023, using data from the Global Burden of Disease Study 2023. Four key indicators—incidence, prevalence, mortality, and disability‐adjusted life years (DALYs)—were extracted and stratified by region and age group. Estimated Annual Percentage Change (EAPC) was calculated to assess long‐term trends, whereas age‐specific and regional disparities were evaluated. Future burden was projected to 2038 using the Autoregressive Integrated Moving Average (ARIMA) model. Although global cervical cancer rates have declined modestly since 1990, Africa has experienced rising trends across all indicators. From 1990 to 2023, the age‐standardized incidence rate in the African Union rose from 17.41 to 23.53 per 100,000 population (EAPC = 0.67, 95% CI: 0.48–0.87), and DALYs increased from 368.58 to 430.7 per 100,000 (EAPC = 0.24, 95% CI: 0.07–0.41). Central, Southern, and Eastern Africa showed the highest burden, with Southern Africa recording the most rapid increase in incidence (EAPC = 1.54). Age‐specific analysis revealed a concentrated burden among women aged 40–54, with absolute case numbers nearly doubling in this group since 1990. Projections suggest a substantial increase in incidence, prevalence, deaths and DALYs by 2038; and the gap between Africa and the global average is expected to widen further, with incidence rates remaining significantly above the WHO elimination threshold of < 4/100,000. Africa's cervical cancer burden is increasing and diverging from global progress. Structural health system limitations, insufficient HPV vaccination coverage, and low screening uptake are key contributors. Urgent, region‐specific interventions—integrating prevention, screening, and treatment—are essential to reverse current trends and achieve WHO elimination goals.