This disease disproportionately affects women in low- and middle-income countries due to limited access to preventive measures such as HPV vaccination and cervical screening. The highest incidence and mortality rates are observed in sub-Saharan Africa, Central America, and South-East Asia, attributed to disparities in healthcare access.
Cervical cancer ranks as the fourth most common cancer among women worldwide, with approximately 660 000 new cases and 350 000 deaths in 2022.
This disease disproportionately affects women in low- and middle-income countries due to limited access to preventive measures such as HPV vaccination and cervical screening.
The highest incidence and mortality rates are observed in sub-Saharan Africa, Central America, and South-East Asia, attributed to disparities in healthcare access. Women between the ages of 35 and 44 are most commonly affected, though all age groups are at risk, especially those without regular screening.
The primary cause of cervical cancer is persistent infection with high-risk Human Papillomavirus (HPV) types, mainly types 16 and 18, which are responsible for about 70% of all cases. Transmission is predominantly through sexual contact. Other risk factors include smoking, having multiple sexual partners, early sexual activity, prolonged use of oral contraceptives, and co-infection with HIV. Women with HIV are notably at a higher risk due to compromised immune systems.
Prevention and control are possible through HPV vaccination, ideally before sexual activity begins, and regular cervical screening like Pap smears and HPV testing. These measures have significantly reduced cervical cancer rates in developed countries.
Mortality rates of cervical cancer and the role of HPV
Cervical cancer remains a significant public health challenge globally, with its burden unevenly distributed across different regions. The age-standardised incidence and mortality rates provide a clear picture of this disparity, influenced heavily by the availability and effectiveness of healthcare resources, including HPV vaccination and cervical cancer screening programmes.
In regions with limited healthcare access, such as parts of Africa and Asia, the incidence and mortality rates are alarmingly high. For instance, in 2022, the global age-standardised incidence rate was estimated at 14.1 per 100 000 women, with approximately 662 000 new cases reported. Similarly, the mortality rate stood at 7.1 per 100 000 women, resulting in about 349 000 deaths. The majority of these cases and fatalities occurred in low- and middle-income countries, underscoring the critical need for enhanced healthcare services and preventive measures in these areas. Conversely, regions like North America and Western Europe, which have more comprehensive prevention and treatment programmes, exhibit significantly lower incidence and mortality rates. This contrast highlights the effectiveness of well-implemented health strategies, including widespread HPV vaccination and regular cervical screening, in reducing the burden of cervical cancer.
The link between HPV and cervical cancer is well documented. Persistent infection with high-risk HPV types, particularly HPV 16 and 18, is the primary cause of cervical cancer. These types account for about 70% of all cases. HPV is predominantly transmitted through sexual contact, and the progression from initial infection to invasive cervical cancer can take several years, providing a critical window for intervention through vaccination and regular screening. The World Health Organization has set an ambitious goal to eliminate cervical cancer as a public health problem by 2030. This goal underscores the importance of addressing HPV, the main etiological factor in cervical cancer, through comprehensive vaccination and screening programmes. Such initiatives are particularly vital in regions with high cervical cancer rates, where they can significantly reduce both incidence and mortality.
Reference
WHO preferred product characteristics for therapeutic HPV vaccines. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO.
