Cervical cancer elimination

What is cervical cancer?

Diagram showing stage 1B cervical cancer
Author: Cancer Research UK​ - CC BY-SA 4.0

Cervical cancer is the uncontrolled growth of abnormal cells in the lining of the cervix. The cervix is part of the female reproductive system and is located in the lower part of the womb, forming the opening from the womb to the vagina.[1]  

Cervical cancer remains one of the most common causes of death for women globally and ranks 4^th of all cancers. Currently, every 2 minutes a life is lost to this disease. Importantly, it is the leading cause of cancer deaths in women in 42 countries.

In 2018, the global mortality statistics increased to 300 000 women for the first time, and these are likely to grow, particularly in underprivileged and vulnerable communities. Current data suggests that 90% of all cases occur in low- and middle-income countries, due largely to poor access to screening and early detection and treatment of both pre-cancers and cancer. [2]

What causes cervical cancer?

Most cervical cancers are caused by Human Papillomavirus (HPV) infections. HPV is a group of viruses that are extremely common worldwide. There are more than 100 types of HPV, of which at least 14 are cancer-causing (also known as high risk types). Two HPV types (16 and 18) cause 70% of cervical cancers and pre-cancerous cervical lesions. There is also evidence linking HPV with cancers of the anus, vulva, vagina, penis and oropharynx.[3]

Virologist Harald zur Hausen discovered how cervical cancer is triggered by virus infections. His work led to the creation of the HPV vaccine which cuts the risk of developing cervical cancer.#WorldCancerDay pic.twitter.com/ZNCQEf5zkV

— The Nobel Prize (@NobelPrize) February 4, 2020

Can cervical cancer be prevented?

Cervical cancer is one of the most preventable and successfully treatable forms of cancer, if it is detected and diagnosed early and managed effectively:

1. Available prophylactic HPV vaccines protect against the common cancer-causing types of human papilloma virus and can significantly reduce the risk of cervical cancer. 
2. Testing for HPV-infection as part of a cervical screening programme in women aged 30-49 followed by the examination of the cervix for pre-cancers (early but visible changes in the cells, before they become cancer) permits local treatment and is a second opportunity to prevent cervical cancer.  

Two recent articles published in The Lancet show that 62 million women's lives could be saved by 2120 if the World Health Organization (WHO) proposed measures for Cervical Cancer elimination are implemented.

This analysis in 78 low-income and lower-middle-income countries describes the mortality impact of achieving WHO cervical cancer elimination targets.

What does UICC do?

UICC works closely with the World Health Organization (WHO), other UN agencies and partners towards the elimination of cervical cancer as a public health problem. UICC fully supports the draft WHO 2020-2030 Global Strategy towards the elimination of cervical cancer which will be presented to the World Health Assembly for approval in May 2020. We are rallying our members and partners in calling for urgent national commitments to help achieve the Sustainable Development Goals (SDGs) by 2030 and the elimination of cervical cancer. 

The elimination initiative suggests a three-part approach:

1. HPV vaccination 
2. screening and early treatment of pre-cancerous lesions and
3. prompt referral for treatment and palliative care of invasive cervical cancer.  

The draft Global Strategy identifies the following threshold: cervical cancer would no longer be considered to be a public health problem when all countries reach an annual incidence rate of 4 cases per 100,000 women or less. This should happen within the lifetime of today’s young girls. [4]

How can civil society organisations help mobilise national support for the global strategy?

• Use the UICC template letter to reach out to your own government for national action

• Urge your government to make a 2022 SMART commitment to mobilise early action towards the 2030 goals.

• Share your own commitment to drive national action – big or small – to the UICC 2022 SMART commitments tracker will aim to launch by World Health Assembly 2020.

Increasing access to screening and treatment to prevent cervical cancer (Special Focus Dialogue)

On 25 June 2020, during a Special Focus Dialogue, cancer, HIV and SRHR advocates came together to:

• Hear an update on the progress of the WHO Global Strategy through the World Health Assembly
• Discuss the impact of COVID-19 on cervical cancer prevention and control services and planning for rapid recovery
• Explore women’s perspectives on cervical health, screening and treatment with civil society groups from the cancer, HIV-AIDS and SRHR fields
• Learn about WHO's new screening guidelines, and the rationale and process for the update
• Explore how to join the global effort by helping to bring the views of women from their communities to inform the new recommendations

Further information (external links)

• WHO call for Action
• Global Strategy on Cervical Cancer Elimination
• IARC Data and Statistics
• WHO Cervical Cancer Page
• OAFLAD and AORTIC call to action towards elimination of Cervical Cancer