Introduction:

Cervical cancer is the fourth most common cancer in women worldwide, and it is caused by persistent infection with the human papillomavirus (HPV). For most countries in the Eastern Mediterranean Region, the incidence rate of cervical cancer was estimated at 10 cases per 100,000 women in 2022. In fact, morbidity and mortality rates remain high due to low acceptance of the HPV vaccine despite widespread vaccination campaigns. This systematic review aimed to estimate the rate of acceptance of the HPV vaccine among adolescent girls in the Eastern Mediterranean Region.

Methods:

The protocol of this study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The following databases were searched from their inception date until February 2025: PubMed, Scopus, Web of Science, and Index Medicus Global. Two independent reviewers, for methodological validity, assessed papers selected for retrieval prior to inclusion in the review using the Joanna Briggs Institute (JBI) critical appraisal checklist . Any disagreements that arose between the reviewers were resolved through discussion, or with a third reviewer.

Results:

The final results of this systematic review will be published in a peer-reviewed journal. We identified a total of 2972 articles. We removed 146 duplicates. A total of 2826 were screened by title and abstract. Then, 47 full-text articles were assessed for eligibility. Overall, 31 studies were included in this review. Eligible studies were performed in Saudi Arabia (n=14), Morocco (n=4), Lebanon (n=4), Palestine (n=2), Qatar (n=1), Oman (n=1), Tunisia (n=1), the UAE (n=1), Syria (n=1), Iran (n=1), and Pakistan (n=1). All of the included studies were cross-sectional. The acceptance rate of the HPV vaccine varied from 2.5% to 40.7%.

Systematic review registration:

The protocol of this study was registered on 10 December 2024 at PROSPERO with the registration number CRD42024620242.