The International Agency for Research on Cancer (IARC) marks Cervical Cancer Awareness Month by highlighting the work that remains to be done for the world to eliminate this disease by the end of this century, and by promoting the tools that are available to achieve this goal.
The main cause of cervical cancer is persistent infection with high-risk types of human papillomavirus (HPV), an extremely common family of viruses that are transmitted through sexual contact. Cervical cancer is one of the most preventable and treatable forms of cancer. However, in 2020, an estimated 604 000 women were diagnosed with cervical cancer worldwide and about 342 000 women died from the disease; most of these cases and deaths (~90% for both) occurred in low- and middle-income countries.
Countries have only 6 years left, until 2030, to meet the World Health Organization (WHO) targets that will help make cervical cancer elimination a reality within this ambitious timeframe. Recent research by scientists from IARC and partner institutions suggests that these targets will be missed unless countries scale up screening programmes, improve coverage of HPV vaccination, and expand access to affordable treatment.
To eliminate cervical cancer as a public health problem by 2100, all countries must reach and maintain an incidence rate of fewer than 4 new cases of cervical cancer per 100 000 women per year. Achieving that goal rests on three key pillars and their corresponding targets:
- Vaccination: 90% of girls fully vaccinated with the HPV vaccine by the age of 15 years;
- Screening: 70% of women screened using a high-performance test by the age of 35 years, and again by the age of 45 years;
- Treatment: 90% of women with precancer treated and 90% of women with invasive cancer managed.
Each country should meet the 90–70–90 targets by 2030 to get on the path towards eliminating cervical cancer by the end of this century.
IARC scientists are conducting research that is advancing these three areas, such as studying the immune response to different numbers of doses of HPV vaccine. Thanks to these evaluations, it is now known that a single dose of vaccine offers adequate protection to neutralize the virus and that immunogenicity of a single dose remains high even 10 years after vaccination. Largely on the basis of these results and related IARC research, WHO recently recommended supporting a single-dose schedule for HPV vaccination.
Researchers at IARC and their collaborators are also evaluating the feasibility and effectiveness of various methods for cervical cancer screening. IARC Handbooks of Cancer Prevention Volume 18: Cervical Cancer Screening was published in May 2022. A recent IARC study reported on the performance of visual inspection of the cervix with acetic acid (VIA), a low-cost screening method, as well as the ability of VIA providers to assess eligibility for ablative treatment.
Recent related IARC research
- Immunogenicity and safety of a new quadrivalent HPV vaccine in girls and boys aged 9–14 years versus an established quadrivalent HPV vaccine in women aged 15–26 years in India: a randomised, active-controlled, multicentre, phase 2/3 trial
- The global cervical cancer burden in 2020 and recent trends in incidence: a baseline assessment for monitoring the WHO Global Cervical Cancer Elimination Initiative: More efforts are needed to reach the WHO 2030 elimination targets
- Evaluation of immune response to single dose of quadrivalent HPV vaccine at 10-year post-vaccination
- Publication of IARC Handbooks of Cancer Prevention Volume 18: Cervical Cancer Screening
- Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women: results from the ESTAMPA study
Related IARC atlases
Atlas of visual inspection of the cervix with acetic acid for screening, triage, and assessment for treatment – English, French, Russian, Ukrainian, Spanish
Using HPV tests for cervical cancer screening and managing HPV-positive women – a practical online guide – English, French, Spanish
Atlas of Colposcopy: Principles and Practice – English, Chinese, French, Spanish, Portuguese
RECENT PUBLICATIONS: SCIENTIFIC EVIDENCE TO SUPPORT CERVICAL CANCER ELIMINATION
PUBLICATIONS ON HPV VACCINATION: EVIDENCE OF ONE-DOSE PROTECTION AND EFFICACY OF NEW VACCINES
- Immunogenicity and safety of a new quadrivalent HPV vaccine in girls and boys aged 9–14 years versus an established quadrivalent HPV vaccine in women aged 15–26 years in India: a randomised, active-controlled, multicentre, phase 2/3 trial
- Evaluation of immune response to single dose of quadrivalent HPV vaccine at 10-year post-vaccination
- Protection from a Single Dose of HPV Vaccine: A major public health impact from IARC studies of vaccine efficacy
- Evidence-based impact projections of single-dose human papillomavirus vaccination in India: a modelling study
- HPV vaccination and screening for cervical cancer
- Recent economic evaluation of 1-dose HPV vaccination uses unsupported assumptions
- Building resilient cervical cancer prevention through gender-neutral HPV vaccination
- Approximating missing epidemiological data for cervical cancer through Footprinting: A case study in India
- An update on one-dose HPV vaccine studies, immunobridging and humoral immune responses – A meeting report
- Human papillomavirus vaccine effect against human papillomavirus infection in Rwanda: evidence from repeated cross-sectional cervical-cell-based surveys
- Barriers and facilitators of HPV vaccination in sub-saharan Africa: a systematic review
- State-of-the-Science of human papillomavirus vaccination in women with human immunodeficiency Virus: Summary of a scientific workshop
- Cognitions and behaviours of general practitioners in France regarding HPV vaccination: A theory-based systematic review
In press:
1- Health and economic effects of introducing single-dose or two-dose human papillomavirus vaccination in India.
Implementation and surveillance of Screening programmes
- CanScreen5: a global data repository for breast, cervical, and colorectal cancer screening programmes
- An international consensus on the essential and desirable criteria for an ‘organized’ cancer screening programme
- IARC and Irish health services publish summary of best practices in cervical screening programmes
- The IARC Perspective on Cervical Cancer Screening
- The IARC Perspective on Cervical Cancer Screening. Reply
- Book Review: IARC handbooks of cancer prevention, volume 18: Cervical cancer screening
- Components and effectiveness of patient navigation programmes to increase participation to breast, cervical and colorectal cancer screening: A systematic review
- Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study
- Assessment of organization of cervical and breast cancer screening programmes in the Latin American and the Caribbean states: The CanScreen5 framework
- Survey of current policies towards widening cervical screening coverage among vulnerable women in 22 European countries
- Implementation of a Pilot Cervical Cancer Screening Programme Integrated in Routine Primary Health-Care Services in Benin, Côte d’Ivoire, and Senegal: Report of a Pilot Project (Care4Afrique) in Three African Countries
- Human papillomavirus testing on self-collected samples to detect high-grade cervical lesions in rural Bhutan: The REACH-Bhutan study
- Cancer in sub-Saharan Africa: a lancet oncology commission
- Implementation of visual inspection with acetic acid and Lugol’s iodine for cervical cancer screening in rural China
- Effectiveness of Artificial Intelligence-Assisted Decision-making to Improve Vulnerable Women’s Participation in Cervical Cancer Screening in France: Protocol for a Cluster Randomized Controlled Trial (AppDate-You).
- Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study
- Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women: results from the ESTAMPA study
- Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus: results from the ESTAMPA multicentric screening study
- Evolution of patterns of care for women with cervical cancer in Morocco over a decade
- ESTAMPA Study Group. Distribution of human papillomavirus genotypes by severity of cervical lesions in HPV screened positive women from the ESTAMPA study in Latin America
- A Systematic Review of Oral Biopsies, Sample Types, and Detection Techniques Applied in Relation to Oral Cancer Detection
- Rising stars in infectious diseases—Surveillance, prevention and treatment: 2022
- Molecular triaging options for women testing HPV positive with self-collected samples
In press:
1- Accuracy of HPV E6/E7 oncoprotein tests to detect high-grade cervical lesions: a systematic literature review and meta-analysis 2- Cervical Cancer Screening and Treatment algorithms using Human Papillomavirus testing – lessons learnt from a South African pilot randomized controlled trial
Treatment and cancer surveillance
- Latin America and the Caribbean Code against Cancer
- Latin America and the Caribbean Code Against Cancer 1st Edition: Medical interventions including hormone replacement therapy and cancer screening
- Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative
- Efficacy and safety of therapeutic HPV vaccines to treat CIN 2/CIN 3 lesions: a systematic review and meta-analysis of phase II/III clinical trials
- Efficacy, acceptability and safety of ablative versus excisional procedure in the treatment of histologically confirmed CIN2/3: A systematic review
- Female Genital Tumours
In press:
1- Benefits, harms and cost-effectiveness of cervical screening and treatment in 78 low-income and lower-middle income countries for women in the general population: modelling to support updated WHO cervical screening and treatment guidelines to prevent cervical cancer and precancerous lesions