In May 2018, the World Health Organization announced that a cosmmitment to cervical cancer elimination. In October 2018, modelers from Australia showed that with current rates of vaccine implementation and screening, cervical cancer could be eliminated in that country within the next ten years. Researchers are working on clinical, implementation and modeling studies to determine the most effective strategies to achieve cervical cancer elimination. We examined prior commitments to disease elimination, modeling data on public health strategies for cervical cancer elimination in high and low-income countries, and possible challenges to successfully achieving elimination in the world’s most vulnerable populations. Cervical cancer elimination, defined as fewer than four cases per 100,000 women, could be achievable in high-income countries (HICs) within the next 25 to 50 years. The speed and ultimate success of elimination is driven by high rates of coverage with the 9-valent vaccine, with screening providing only a small contribution. The most effective models in low- and middle-income countries (LMICs) include targeting female adolescents for two-dose vaccination, followed by either one or two lifetime screens. Challenges include a global shortage of the 9-valent vaccine, slower than anticipated roll-out to GAVI countries and low uptake rates in countries with vaccination programs. Remarkable advances in biomedical technologies have made cervical cancer elimination a potentially attainable goal within the next generation. Focusing efforts on widespread and effective implementation of evidence-based strategies to prevent the disease will be crucial. We must work to ensure that progress toward elimination is shared equally between HICs and LMICs to avoid a perpetuation of the global health disparity seen in cervical cancer.
Disclosure No significant relationships.
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