Depression among women with cervical cancer: a systematic review and meta-analysis of available evidence

Abstract

BACKGROUND: Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Cervical cancer remains a significant global health challenge, particularly affecting women in low- and middle-income countries. Beyond its physical implications, cervical cancer is associated with a high prevalence of depression, which adversely impacts patients' quality of life and treatment outcomes. Understanding the global prevalence and associated factors of depression among women with cervical cancer is essential for developing targeted mental health interventions and improving comprehensive cancer care. The definition and "cutting point" (threshold) of depression is a critical piece of psychiatric literature. It challenges the medical assumption that Major Depressive Disorder (MDD) is a discrete, biological category that one either "has" or "does not have." METHODS: This systematic review and meta-analysis adhered to PRISMA guidelines to assess the pooled prevalence of depression among women with cervical cancer worldwide. A comprehensive search was conducted across PubMed, Google Scholar, Science Direct, and other databases up to February 05 ,2026. Studies included were original, English-language research employing cross-sectional, case-control, cohort, or descriptive designs that reported prevalence data. Data from 20 eligible articles involving 23,825 participants were extracted and analysed using STATA version 17. A random-effects model estimated the pooled prevalence, with heterogeneity assessed via I² and subgroup analyses conducted based on study year, continent, and study design. RESULTS: The pooled prevalence of depression among women with cervical cancer was estimated at 38.02% (95% CI: 29.00%, 47.05%), with significant heterogeneity (I² = 99.6%). Subgroup analysis revealed higher prevalence rates in studies conducted in Africa (52.51%) and after 2020 (49.15%), whereas studies in Europe reported lower rates (12.26%). The prevalence was higher in cross-sectional studies (48.80%) compared to other designs. Publication bias was detected, and the trim-and-fill method adjusted the pooled prevalence to approximately 24.27%. Sensitivity analysis confirmed the robustness of these findings. CONCLUSION AND RECOMMENDATIONS: Depression is highly prevalent among women with cervical cancer globally, underscoring the necessity for routine mental health screening and psychosocial support integration into cancer care. The significant heterogeneity and regional disparities highlight the importance of context-specific interventions. Healthcare providers should incorporate systematic depression screening and mental health services into cervical cancer management protocols. CLINICAL TRIAL NUMBER: Not applicable.