{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:56:23Z","timestamp":1791291383172,"version":"4.3.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Epidemiol Glob Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cervical cancer is the second most frequent cancer among Somali women, with approximately 1,055 diagnoses and 812 deaths annually; however, evidence to guide control efforts is scarce. This systematic review synthesizes the burden, screening findings, and knowledge gaps to inform policy and practice in Somalia\u2019s resource-limited settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA 2020, we searched PubMed, Scopus, Embase, ScienceDirect, DOAJ, Cochrane Library, and Google Scholar without date limits for English, peer-reviewed studies from Somalia reporting prevalence, incidence, knowledge, screening, and prevention. Two reviewers independently extracted the data and performed the JBI critical appraisal for cross-sectional studies. Given the heterogeneity, we conducted a narrative synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven cross-sectional studies (2019\u20132024) with 3,797 participants from Mogadishu, Hargeisa, and Bosaso were included in this review. Across facility-based studies, cervical cancer accounted for 6.7% of all cancers and 13.3% of female cancers, while screening positivity among women attending screening services ranged up to 15.7%. The prevalence of cervical cancer ranged from 6.7% to 15.7%. Among 189 women sampled in Mogadishu (clinic-based), 31.7% were HPV DNA-positive, including 19.6% high-risk types (HPV16 13.8%, HPV18 5.3%); these findings may not represent national HPV prevalence. Among healthcare professionals, 73% had good theoretical knowledge; however, only 24% had treated a cervical-cancer patient, 22% reported receiving specific training, and only 2% of female providers had undergone Pap testing. Women\u2019s awareness varied widely (43.7\u201397.7%), and misconceptions were common. In one facility-based screening study, VIA positivity was 7.6% compared with 5.1% for Pap smear (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). Among women who were VIA-positive and underwent confirmatory assessment, 73.9% had CIN on colposcopy\/biopsy; however, biopsy-confirmed CIN2+\/cancer outcomes by each test and verification pathways were not fully reported, limiting direct comparison of diagnostic performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Somalia faces a high burden of cervical cancer and HPV infection, compounded by limited screening coverage, training gaps among providers, and misinformation among women about HPV vaccination. Priority actions include establishing a national cancer registry, expanding HPV vaccination, scaling context-appropriate screening (VIA and HPV testing), delivering targeted public education, and strengthening provider training especially for female frontline staff using culturally sensitive approaches to improve uptake and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s44197-026-00526-x","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T03:23:13Z","timestamp":1772076193000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Current Cervical Cancer Status in Resource-Limited Somalia: a Systematic Review of Burden, Screening Findings, and Knowledge Gaps"],"prefix":"10.1007","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3401-8383","authenticated-orcid":false,"given":"Najib Isse","family":"Dirie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3260-2860","authenticated-orcid":false,"given":"Mulki Mukhtar","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5991-4052","authenticated-orcid":false,"given":"Mohamed Mustaf","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihaan","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashiru","family":"Garba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleh Abdulkadir Saeed","family":"Al-Duais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Massi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"526_CR1","unstructured":"Cervical cancer. 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