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

The World Health Organization launched a Global Strategy to Accelerate the Elimination of Cervical Cancer. The three key steps for elimination of cervical cancers are vaccination, screening and treatment. Successful implementation of all three could reduce more than 40% of new cases of the disease and 5 million related deaths by 2050.

Recommended: Cervical and Breast Cancer Screening Program Implementation Guideline 2077 (Nepal)

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 90-70-90 targets that must be met by 2030 for countries to be on the path towards cervical cancer elimination,

Targets 2030

• 90% of girls fully vaccinated with the HPV vaccine by 15 years of age.
• 70% of women screened using a high-performance test by age 35 and again by 45.
• 90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated and 90% of women with invasive cancer managed).

The global strategy to eliminate cervical cancer as a public health problem will require;

• Political support from international and local leaders;
• Coordinated cooperation among multi-sectoral partners;
• Broad support for equitable access in the context of universal health coverage;
• Effective resource mobilization;
• Health system strengthening; and
• Vigorous health promotion at all levels.
• The interconnected nature of gender and health must stand as the strategic centrepiece of interventions.

Strategic actions to achieve the 2030 targets

Primary Prevention
Girls 9–14 years
– HPV vaccination
Girls and boys, as appropriate
– Health information and warnings about tobacco use
– Sexuality education tailored to age and culture
– Condom promotion/provision for those engaged in sexual activity
– Male circumcision.

Secondary Prevention
Women > 30 years of age
– Screening with a high performance test equivalent to or better than HPV test
– Followed by immediate treatment or as quickly as possible, of precancerous lesions.

Tertiary Prevention
All women, as needed
Treatment of invasive cancer at any age
– Surgery
– Radiotherapy
– Chemotherapy
– Palliative care

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Recommended readings

• Cervical and Breast Cancer Screening Program Implementation Guideline 2077
• Accelerate efforts to eliminate cervical cancer: WHO
• Prevention and Control of Cervical Cancer (New WHO guide)
• World Cancer Day 2020: ”I Am and I Will” #WorldCancerDay