Cervical Cancer

Cervical cancer is preventable, owing to effective primary prevention via human papillomavirus (HPV) vaccination and secondary prevention via screening. However, it remains the fourth most common cancer and the third leading cause of cancer death in women worldwide, with 662,000 new cases and 350,000 deaths estimated in 2022. There is a 45-fold difference in cervical cancer incidence rates across countries (Figure 17.1) due to uneven progress made against the disease (Figure 17.2).

Efforts to reduce the cervical cancer burden are particularly critical in sub-Saharan Africa, where incidence rates are the highest in the world (Figure 17.1) and the disease remains the leading cause of cancer death in women in 29 countries (Map 17.1).

To achieve the goal of incidence rates of less than four per 100,000 women set by the World Health Organization (WHO) Cervical Cancer Elimination Initiative (CCEI), each country should meet the 90-70-90 targets aiming at 90% of age-eligible girls being HPV-vaccinated, 70% of age-eligible women having ≥1 lifetime cervical screening, and 90% of women with precancerous and cancerous cervical lesions being treated effectively, by the year 2030 (Figure 17.3).

Nevertheless, by 2019, nearly two decades after the HPV vaccines were recommended by the WHO, only 1% of girls in Northern Africa and Western Asia were vaccinated (first dose), compared with 86% in Australia and New Zealand (see Vaccination, Figure 35.2). In 2019, only one in three women aged 30-49 years had ever been screened for cervical cancer, and 63 of 202 countries did not have official screening recommendations as of 2021. In 2023, the high-performance HPV detection-based screening has been rolled out in only 19 countries, all of which are high-income countries (see Early Detection, Map 36.1).