Uptake of cervical cancer screening and its associated factors in Africa: an umbrella review of systematic reviews and meta-analyses.

backgroundCervical cancer poses a major public health burden in low- and middle-income countries, especially in Africa, despite being largely preventable through HPV vaccination and screening. This umbrella review synthesizes findings from systematic reviews and meta-analyses to identify factors influencing screening uptake, offering evidence to guide targeted interventions and policy responses across the continent.

methodThis umbrella review synthesized evidence from systematic reviews and meta-analyses on cervical cancer screening uptake and associated factors among African women. The protocol was registered in PROSPERO (CRD42025639740). A systematic search across five electronic databases, guided by the PICO framework, identified studies reporting prevalence, facilitators, or barriers. After duplicate removal, studies underwent title, abstract, and full-text screening. Data on study characteristics, screening prevalence, and associated factors were extracted. Quality was assessed using AMSTAR-2. A random-effects model in R software was used to estimate pooled prevalence and associated factors. Heterogeneity was evaluated via the I² statistic (> 75% indicating substantial variation), and publication bias was examined using funnel plots and Egger’s regression test.

resultThis umbrella review included 11 systematic reviews comprising 214 cross-sectional studies with a total sample of one hundred forty-three thousand women across Africa. The pooled cervical cancer screening uptake was 19% (95% CI: 12–25%), with substantial heterogeneity (I² = 99.9%, p < 0.001). Key factors associated with higher uptake included formal education, employment in the public sector, knowledge of cervical cancer, perceived risk and severity, prior sexually transmitted infections, and getting healthcare providers’ advice.

conclusionCervical cancer screening uptake remains low across Africa, with increased uptake linked to formal education, knowledge, perceived susceptibility, and provider advice. These findings call for targeted, multi-level interventions to improve health literacy, awareness, and provider engagement. Policymakers should strengthen health systems and implement culturally appropriate, community-based strategies to expand access. Given the high heterogeneity (I² = 100%), findings should be interpreted cautiously. Future research should prioritize context-specific, evidence-based approaches to overcome barriers and ensure equitable screening uptake.