The Psychological Burden of Cervical Cancer in Sub-Saharan Africa: Distress, Shame, and the Case for Integrated Task-Sharing Mental Health Care — A Narrative Review

Background/Aims Cervical cancer is the leading cause of cancer death among women in sub-Saharan Africa, where late diagnosis, limited treatment infrastructure, and culturally specific shame linked to HPV aetiology compound its physical burden. Psychosocial care remains largely absent from cervical cancer programmes across the region despite growing evidence of its clinical importance. This narrative review synthesises evidence on the prevalence, determinants, and clinical consequences of psychological distress in women with cervical cancer in sub-Saharan Africa, and examines the evidence base for task-sharing mental health interventions applicable to this context. Methods PubMed, PsycINFO, and Global Health databases were searched for peer-reviewed literature published through December 2024, combining terms for cervical cancer, sub-Saharan Africa, psychological distress, depression, anxiety, task-sharing, and psycho-oncology. Systematic reviews, observational studies, qualitative research, and intervention trials were included and narratively synthesised. Results Depression affects 20–38% and anxiety 30–52% of women with cervical cancer in sub-Saharan Africa. Distress is shaped by advanced disease stage, financial toxicity, HIV co-infection, and HPV-related stigma and shame. Standard screening instruments (PHQ-9, HADS) are widely used but lack formal validation in local languages. Task-sharing interventions delivered by community health workers, nurses, and social workers demonstrate consistent reductions in distress with high acceptability, though cervical-cancer-specific trials in the region remain scarce. Conclusions Psychological distress in this population is prevalent, culturally distinctive, and clinically consequential. Culturally adapted task-sharing interventions should be integrated into cervical cancer care pathways as a clinical and ethical priority. Validated screening tools and rigorous trials are urgently needed.