Primary and secondary prevention of cervical cancer

The burden of cervical cancer is very high in low-resource countries, while it is lower in several high-income countries. Secondary prevention based on cervical screening has been very successful in countries where the resources exist to ensure high-quality and good coverage of the population at risk. In many developed countries that have effective organized screening programs, cervical cancer incidence and mortality rates have been reduced substantially. However, the cervical screening is generally inefficient and unworkable in the many regions of the world where the appropriate infrastructure is missing. Primary prevention by prophylactic vaccination against the major cause of cervical cancer, the carcinogenic human papillomavirus types 16 and 18, is now available worldwide and offers additional protection from cervical cancer. This review focuses on basic knowledge about cervical cancer and challenges in the new era of cervical cancer prevention.