Global cervical cancer elimination: quantifying the status, progress, and gaps.

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• The World Health Organization (WHO) has initiated a global commitment for cervical cancer (CC) elimination, involving 194 countries.
• Progress in CC elimination is assessed through the implementation of primary (human papillomavirus [HPV] vaccination), secondary (CC screening), and tertiary (CC treatment) prevention strategies.
• Interim targets for the Global Strategy for Cervical Cancer Elimination are evaluated.

Purpose of the Study:

• To quantitatively assess global progress towards cervical cancer elimination targets.
• To analyze the implementation of HPV vaccination, CC screening, and CC treatment across 194 countries.
• To identify disparities in CC prevention and treatment based on national income and geographic location.

Main Methods:

• Data were collected from the International Agency for Research on Cancer, WHO, UNICEF, and national capacity surveys.
• A retrospective analysis examined data from 194 countries and regions, stratified by income (high-income countries [HICs] vs. low- and middle-income countries [LMICs]) and geography.
• Quantitative assessment of global progress in primary, secondary, and tertiary CC prevention.

Main Results:

• By 2020, only four countries met the target of 90% HPV vaccination coverage for girls by age 15.
• As of 2021, 115 countries had integrated HPV vaccination into national programs, and 133 countries had implemented CC screening programs.
• While 126 countries have national CC management guidelines, tertiary prevention indicators like opioid consumption suggest underutilization of treatment services, especially in LMICs.

Conclusions:

• Significant inequalities in CC vaccination and screening access persist globally, with limited access in most LMICs.
• Targeting vulnerable populations and economically underdeveloped regions is essential to reduce inequity and accelerate CC elimination.
• Tertiary prevention appears more established in LMICs, but indirect indicators suggest underutilization of cancer treatment services.