WHO Strategy on elimination
To eliminate cervical cancer, all countries must reach and maintain an incidence rate of below four per 100 000 women. Attaining this goal requires strategic action, and WHO outlines the necessary actions in its global strategy, envisioning a world where cervical cancer is eliminated as a public health problem and keeping the 2030 agenda on SDGs.
- Prevention through vaccination
- Screening and treatment of precancerous lesions
- Treatment and palliative care for invasive cervical cancer
All three pillars must be implemented collectively and at scale to achieve the goal of elimination. HPV vaccination offers long-term protection against cervical cancer. Screening and treatment of precancerous lesions can prevent pre-cancer from developing into cancer. For those who are identified with invasive cancer, timely care and treatment saves lives, while palliative care can greatly reduce pain and suffering.
Based on the three key pillars of the global strategy, WHO recommends a set of targets or milestones that each country should meet by 2030 to get on the path to eliminate cervical cancer within the century:
- 90% of girls fully vaccinated with the HPV vaccine by the age of 15;
- 70% of women screened using a high-performance test by the age of 35, and again by the age of 45; and
- 90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated and 90% of women with invasive cancer managed).
Projections show that achieving the 90-70-90 targets by 2030 can reduce the median cervical cancer incidence rate by 10% by 2030, and by 2120, 70 million cases could be averted. Additionally, an estimated 62 million cervical cancer deaths could be averted by 2120. In the meantime, implementing the strategy will save lives today.
A robust monitoring system, including population-based cancer registries, is essential to keep track of the progress and to make course corrections.