WHO strategy to fight cervical cancer

Schriftzug: World Health Organization (Shutterstock.com/Skorzewiak)

The WHO’s cervical cancer strategy has been in place since 2020, when the World Health Organization highlighted that cervical cancer still is the fourth most common cancer in women worldwide. In 2018, the disease claimed the lives of more than 300 000 women, despite the fact that cervical cancer is actually easily treatable or even preventable. This prompted the WHO to act.

Avoiding cervical cancer

There are two important measures for preventing cervical cancer from developing:

  • Vaccination against HPV: Cervical cancer is caused by an infection with human papillomaviruses. In most cases, an HPV infection heals on its own, without any symptoms. In rare cases, a long-term infection with HPV causes changes in the tissue. These can regenerate on their own – or develop into cervical cancer via precancerous lesions. Almost everyone becomes infected with HPV in the course of their life. The viruses are sexually transmitted. Unfortunately, condoms do not provide sufficient protection against HPV transmission.
  • Cervical cancer screening: Cervical cancer develops slowly, usually over several years. Therefore, this type of cancer can be detected very well already in its preliminary stages. A good cancer screening programme is a prerequisite for diagnosing and treating cervical cancer early. In most countries, the Pap test and HPV tests are used for this purpose. In a Pap test, a cervical smear sample is examined for abnormal cells under the microscope. An HPV test detects an existing infection with high-risk HPV.

Diagnosing cervical cancer

The Pap and HPV tests primarily give an indication that a woman is at risk of developing or, in rare cases, already having the disease. To diagnose cervical cancer with certainty, requires further examinations. Here, too, the procedure is similar in most countries:

  • Watchfull Waiting or waiting: depending on the severity of the abnormality detected during cancer screening, the affected woman is called back in at shorter intervals. The tests are then repeated to see if there are any changes.
  • Colposcopy: The colposcope is a special examination microscope used to look closely at the affected areas of the cervix. For this examination, the woman has to go to a specialist consultation, because not every gynaecologist can carry out a colposcopy himself. This may mean waiting times for an appointment.
  • Test based on epigenetic biomarkers: A test for cervical cancer that uses epigenetic biomarkers to diagnose cervical cancer looks directly into the affected cells. It is used for triaging women with abnormal Pap test or positive HPV test result. It examines the DNA of the cells and can reliably clarify if these women are really at risk of developing or already having cervical cancer. For this type of diagnosis, a swab sample, like the one the gynaecologist takes from the cervix for Pap and HPV tests, is sufficient.

WHO strategy to fight cervical cancer

In 2020, the World Health Assembly adopted a Global Strategy to fight Cervical Cancer. As a target, the organisation calls on all countries to reduce their incidence rate to four per 100 000 women. To achieve this goal, the WHO relies on three central pillars:

  • Vaccination: 90% of girls fully vaccinated with the HPV vaccine by the age of 15;
  • Screening: 70% of women screened using a high-performance test by the age of 35, and again by the age of 45;
  • Treatment: 90% of women with pre-cancer treated and 90% of women with invasive cancer managed

According to WHO, these targets should be reached by 2030 so that cervical cancer can be called eliminated.



Source: WHO – World Health Organization

Cover picture: www.Shutterstock.com/Skorzewiak