Global strategy to accelerate the elimination of cervical cancer as a public health problem

Overview

Cervical cancer is a preventable disease. It is also curable if detected early and adequately treated. Yet it remains one of the most common cancers and causes of cancer-related death in women across the globe. Few diseases reflect global inequities as much as cancer of the cervix. In low- and middle-income countries its incidence is nearly twice as high and its death rates three times as high as in high-income countries.

Proven and cost-effective measures for eliminating cervical cancer exist, but to date have not been widely implemented in regions of the world where the disease burden is highest. To be optimally effective, these measures must be scaled to national levels and delivered using health service platforms that are sensitive to women’s needs, their social circumstances, and the personal, cultural, social, structural and economic barriers hindering their access to health services. Health services that are integrated and people centred, and that respect and uphold women’s rights and dignity, are vital.

Urgent and bold action is needed to scale up and sustain implementation of the evidence-based interventions (human papillomavirus (HPV) vaccination, cervical cancer screening and management of detected disease) for eliminating cervical cancer as a public health problem, but such action must be strategic.

This global strategy to eliminate cervical cancer proposes:

• a vision of a world where cervical cancer is eliminated as a public health problem;
• a threshold of 4 per 100 000 women-years for elimination as a public health problem;
• the following 90-70-90 targets that must be met by 2030 for countries to be on the path towards cervical cancer elimination:
  • 90% of girls fully vaccinated with HPV vaccine by age 15 years
  • 70% of women are screened with a high-performance test by 35 years of age and again by 45 years of age
  • 90% of women identified with cervical disease receive treatment (90% of women with invasive cancer managed).