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ESMO contributes to the WHO Global Strategy to Accelerate the Elimination of Cervical Cancer adopted by 194 WHO Member States

07 Aug 2020

In February 2020, ESMO endorsed the World Health Organization’s (WHO) Global strategy to accelerate the elimination of cervical cancer as a public health problem with an official statement at the WHO Executive Board Meeting in Geneva.

Several members of the ESMO Faculty Group on Gynecological Cancer provided input to the WHO strategy and in particular on the topic of the management of invasive cervical cancer. ESMO’s participation in this WHO project raised awareness that the ESMO Clinical Practice Guidelines on Cervical Cancer, and Supportive and Palliative Care can help countries achieve the goal of 90% treatment and care for cervical cancer cases through use of evidence-based treatment protocols. The ESMO Patient Guide on Cervical Cancer can also be a useful resource to help patients understand their treatment options.

As a follow-up to the 2020 World Health Assembly, the 194 WHO Member States adopted the WHO Resolution on Global strategy to accelerate the elimination of cervical cancer as a public health problem and its associated goals and targets for the period 2020–2030. The Resolution includes adoption of the global strategy towards eliminating cervical cancer and achieving the ’90-70-90’ interim targets below by 2030:

  • 90% of girls are fully vaccinated with the HPV vaccine by 15 years of age
  • 70% of women are covered by screening with a high-performance test
  • 90% of women identified with cervical disease receive treatment.

Achieving these targets would see the median cervical cancer incidence rate fall by 10%, setting the world on the path to avert 70 million cases in the century.

The ‘elimination’ of cervical cancer is defined by WHO as attaining and maintaining an incidence rate below 4 per 100’000 women.  WHO fact sheets note that currently cervical cancer is the fourth most common cancer among women globally with 569,847 new cases and 311,365 deaths in 2018, with the majority of those cases in low- and middle-income countries.

The WHO country profiles also provide some statistics on vaccination, screening and early detection programs for cervical cancer by WHO region and by country.

WHO has provided a list of interventions necessary to address cervical cancer in the article How to reduce the impact of cervical cancer worldwide: Gaps and priority areas identified through the essential cancer and primary care packages: An analysis of effective interventions. The article is based on 2017 data from the WHO Noncommunicable Disease Country Capacity Survey. In the article the authors assess the availability of health services for cervical cancer in the 194 WHO Member States, and the percentage of countries that offer or reimburse those services for their citizens. The authors propose 2 sets of intervention packages. The first is an Essential Cancer Package with 9 interventions: HPV vaccination, cervical screening, early diagnosis, pathology, radiation, surgery, chemotherapy, palliative care, and a cancer registry to monitor the process and measure progress. The second is a Primary Care Package with 5 interventions which includes HPV vaccination, cervical screening, early diagnosis, palliative care, and a non-communicable disease plan necessary to coordinate national cancer services. The data from the WHO survey shows that only 21% of countries offer their citizens the Essential Cancer Package of 9 interventions and 19.1% the Primary Care Package. Implementing the WHO global strategy to accelerate the elimination of cervical cancer as a public health problem represents an important step to address these gaps in cervical cancer health services and their delivery. The integration of the WHO strategy on cervical cancer into national universal health coverage packages can contribute to the reduction of premature deaths from cancer by 25% by 2025, and 33% by 2030, and the achievement of Universal Health Coverage called for by the 2017 WHO Cancer Resolution.

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