Background: Cervical cancer is a major health challenge in low- and middle-income countries (LMICs), where households face high out-of-pocket costs and limited financial risk protection (FRP). Insufficient FRP for treatment leads to catastrophic health expenditure (CHE), impoverishing health expenditure (IHE) and distress financing.

Objective: This review aimed to synthesise evidence and highlight gaps related to FRP and distress financing (cost-coping strategies) associated with treatment-related cervical cancer care in LMICs.

Methods: A systematic search of PubMed, Scopus, Cochrane Library and EBSCOhost was conducted on 1 July 2024 for peer-reviewed observational studies published from 1 January 2003. Using the Population, Exposure and Outcome framework, the review focused on women with cervical cancer or caregivers (Population), treatment and follow-up care (Exposure) and outcomes on CHE, IHE and cost-coping strategies (Outcome). Eligible studies were quantitative or qualitative with independently extractable outcomes.

Results: Twenty-nine studies (10 quantitative and 19 qualitative) met the inclusion criteria. Evidence on FRP for cervical cancer in LMICs remains scarce. Only four studies reported on CHE, with incidence ranging from 62% to 86%, all using unadjusted thresholds. No studies assessed IHE. Common coping strategies included selling assets and borrowing, while forgoing care for financial reasons was rarely examined. Predictors and long-term impacts of distress financing remain underexplored.

Conclusion: This study underscores the need for more research into the financial burden associated with cervical cancer treatment in LMICs and calls for stronger financial protection measures to mitigate these hardships.