Cervical screening programmes, which detect signs of pre-cancer or cancer in a sample of cells from a person’s cervix, were established in many countries between the 1960s and 1980s, marking a major advance in women’s health. Most modern screening programmes also look for the presence of human papillomavirus (HPV), which is the sexually transmitted virus that causes most cases of cervical cancer. The introduction of these screening programmes has resulted in huge decreases in the incidence of, and mortality from, cervical cancer. The incidence of the disease has already decreased by more than 50% in Nordic countries and 75% in the US, but it is estimated that well-organised screening programmes could reduce it by up to 80%.
Adding to the success of screening, vaccination against HPV has been a key development in cervical cancer prevention. The vaccination of young women can reduce the incidence of cervical cancer by nearly 90%, and the vaccination of young men can lower the incidence of some other HPV-related cancers and reduce the spread of the virus overall.
These two strategies – screening and vaccination – are the mainstays of cervical cancer prevention. The World Health Organization (WHO) recommends a comprehensive approach across the life course to address the known risk factors for HPV and cervical cancer. This approach involves HPV vaccination during adolescence, education about tobacco use and safer sex practices, routine screening in adulthood and treatment where necessary. A comprehensive approach has already been successfully implemented in the UK and a number of other high-income countries, demonstrating the value of intervening early and at various points along the life course.