The fight against cervical cancer

Cervical cancer is the fourth most common cancer among women globally. In the European region, there are more than 66,000 new cases and over 30,000 deaths each year. Cervical cancer is one of the most preventable forms of cancer. To raise awareness of this disease, January is Cervical Cancer Awareness Month.

What is cervical cancer and how is it caused?

Cervical cancer is a cancer that is found anywhere in the cervix – the narrow end of the uterus that connects the uterus and vagina. Almost all (more than 95%) cervical cancer cases are caused by the human papillomavirus (HPV), the most frequent sexually transmitted viral infection.

The World Health Organization (WHO) estimates 300 million women currently have an HPV infection.

Although most sexually active men and women will be infected at some point in their lives, 90% of HPV infections clear up on their own. However, there is a small risk for all women that the infection becomes chronic, and the pre-cancerous lesions develop into invasive cervical cancer.

What increases the risk of cervical cancer?

WHO has identified various factors that can make certain women more susceptible to developing cervical cancer.

Poverty is a key risk. In 2020, 90% of cervical cancer diagnosis and deaths occurred in low- and middle-income countries. Statistics in England, for example, show incidence rates are much higher in deprived populations and each year around 520 cases are linked to poverty. In Scotland, women living in areas of high deprivation are more likely to miss their cervical screening appointment.

Women living with HIV are six times more likely to develop cervical cancer compared to women without. Although it normally takes 15 to 20 years for an HPV infection to progress to cancer, in women with weakened immune systems, such as those with untreated HIV infection, cervical cancer can develop in as little as five to 10 years.

Smoking can also increase a woman’s chance of developing cervical cancer. Tobacco use reduces the body’s ability to fight HPV infection.

How can the risk of cervical cancer be reduced?

As cervical cancer is primarily caused by the HPV virus, WHO emphasises the importance of HPV vaccination programmes.

In the UK and Ireland, girls and boys aged between 12 and 13 are offered the vaccine which is followed by a booster dose.

Studies from the UK show HPV vaccination reduced pre-cancerous lesions and cervical cancer by almost 90% among the first cohorts who received the vaccine. Sweden predicts cervical cancer could be eliminated in the coming years.

Sex education and condom use can also reduce the spread of sexually transmitted infections such as HPV.

WHO also recommends all adult women should undergo periodic cervical cancer screening to check for changes to cervical cells before they turn cancerous.

In the UK and Ireland, women aged 25 to 65 are invited for screenings every three to five years. CervicalCheck, Ireland’s national cervical screening programme, says it has an uptake of almost 80%. In the UK, 69.9% of eligible women were adequately screened in 2021-2022.

Eliminating cervical cancer

WHO seeks to eliminate cervical cancer in its entirety, and by 2030 wants to see:

  • 90% of girls fully vaccinated with the HPV vaccine by age 15;
  • 70% of women screened using a high-performance test by age 35, and again by age 45;
  • 90% of women identified with cervical disease receive treatment.

“Together, let’s end cervical cancer and save lives,” said WHO Director-General Tedros Adhanom Ghebreyesus.

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