Taylor Morris

Cervical cancer prevention offers a valuable opportunity to address global inequalities and improve women’s health

16 January 2023

Effective strategies to prevent cervical cancer have been implemented in many countries, but millions of women in low- and middle-income countries are missing out – resulting in hundreds of thousands of avoidable deaths each year.

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.

The World Health Organization recommends a comprehensive approach of screening and vaccination across the life course to address the known risk factors for HPV and cervical cancer.

Vast inequalities remain both within and between countries

Despite the development and implementation of effective prevention strategies, cervical cancer remains the fourth most common cancer among women around the world. Nearly 90% of all deaths from cervical cancer occur in low- and middle-income countries (LMICs), and the difference in incidence between some countries is as high as 20-fold, with many African countries having the highest rates. These disparities result from various factors, including the limited implementation of HPV vaccination programmes, screening programmes and cancer treatment services in LMICs. Another factor is the increased risk of cervical cancer among people with HIV, which is also more common in some LMICs, particularly in sub-Saharan Africa.

In high-income countries, where national programmes usually provide key preventive services, inequalities are also common. In particular, there tend to be disparities in screening uptake across groups of different ages, ethnicities and socioeconomic positions. In the US, Hispanic women are more likely than those belonging to other ethnic groups to develop cervical cancer. However, Black women are much more likely to die from the disease than women of other races. In the UK, there is a clear association between cervical cancer risk and deprivation; women living in the most deprived areas are nearly 2.5 times as likely to die from the disease as women living in the least deprived areas.

sample on a microscope slide being placed into a scanner by a scientist

Despite the development and implementation of effective prevention strategies, cervical cancer remains the fourth most common cancer among women around the world.

We can eliminate cervical cancer through greater prevention and treatment efforts

The elimination of cervical cancer is defined as all countries achieving an incidence rate below four cases per 100,000 women. To achieve this, the WHO has set ambitious 2030 targets for vaccination, screening and treatment. Countries will face different challenges in achieving these targets, ranging from making existing programmes accessible to disadvantaged groups to implementing new programmes where they do not yet exist. But the technology is well established, and there are many good examples of successful programmes from around the world. Elimination is within reach, and the global community should take this opportunity to come together to achieve cervical cancer prevention targets and save the lives of countless women from all backgrounds and in all countries.

Cervical cancer prevention offers a valuable opportunity to address global inequalities and improve women’s health

Effective strategies to prevent cervical cancer have been implemented in many countries, but millions of women in low- and middle-income countries are missing out – resulting in hundreds of thousands of avoidable deaths each year.

Recent blogs

Vast inequalities remain both within and between countries

We can eliminate cervical cancer through greater prevention and treatment efforts

The opinions expressed in this blog are those of the author and do not necessarily represent the views of The Health Policy Partnership.