Cervical cancer is the fourth most common cancer among women globally, with an estimated 604 000 new cases and 342 000 deaths in 2020.
About 90% of the new cases and deaths worldwide in 2020 occurred in low- and middle-income countries (1).
Two human papillomavirus (HPV) types (16 and 18) are responsible for nearly 50% of high grade cervical pre-cancers
HPV is mainly transmitted through sexual contact and most people are infected with HPV shortly after the onset of sexual activity. More than 90% of them clear the infection eventually.
Women living with HIV are 6 times more likely to develop cervical cancer compared to women without HIV.
Vaccination against HPV and screening and treatment of pre-cancer lesions is a cost-effective way to prevent cervical cancer.
Cervical cancer can be cured if diagnosed at an early stage and treated promptly.
Comprehensive cervical cancer control includes primary prevention (vaccination against HPV), secondary prevention (screening and treatment of pre-cancerous lesions), tertiary prevention (diagnosis and treatment of invasive cervical cancer) and palliative care.
Worldwide, cervical cancer is the fourth most frequent cancer in women with an estimated 604 000 new cases in 2020. Of the estimated 342 000 deaths from cervical cancer in 2020, about 90% of these occur in low- and middle-income countries. Women living with HIV are 6 times more likely to develop cervical cancer compared to women without HIV, and an estimated 5% of all cervical cancer cases are attributable to HIV (2). Moreover, in all world regions the contribution of HIV to cervical cancer falls disproportionately on younger women.
In high-income countries, programmes are in place which enable girls to be vaccinated against HPV and women to get screened regularly and treated adequately. Screening allows pre-cancerous lesions to be identified at stages when they can easily be treated.
In low-and middle-income countries, there is limited access to these preventative measures and cervical cancer is often not identified until it has further advanced and symptoms develop. In addition, access to treatment of cancerous lesions (for example, cancer surgery, radiotherapy and chemotherapy) may be limited, resulting in a higher rate of death from cervical cancer in these countries.
The high mortality rate from cervical cancer globally (age standardized rate among women: 13.3/100 000 in 2020) could be reduced by effective interventions at different stages of life.
HPV and cervical cancer
A large majority of cervical cancer (more than 95%) is due to the human papillomavirus (HPV).
HPV is the most common viral infection of the reproductive tract. Most sexually active women and men will be infected at some point in their lives, and some may be repeatedly infected. More than 90% of the infected populations eventually clear the infection.
Cervical cancer is by far the most common HPV-related disease. Nearly all cases of cervical cancer can be attributed to HPV infection.
Although most HPV infections clear up on their own and most pre-cancerous lesions resolve spontaneously, there is a risk for all women that HPV infection may become chronic and pre-cancerous lesions progress to invasive cervical cancer.
It takes 15 to 20 years for cervical cancer to develop in women with normal immune systems. It can take only 5 to 10 years in women with weakened immune systems, such as those with untreated HIV infection.
Cervical cancer control: a comprehensive approach
The Global strategy towards eliminating cervical cancer as a public health problem, adopted by the World Health Assembly in 2020, recommends a comprehensive approach to cervical cancer prevention and control. The recommended actions include interventions across the life course.
Credit : WHO
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