Cervical cancer: the cancer of inequalities

Cervical cancer is an unfortunate indicator of global health inequities. Worldwide, cervical cancer is the 4th most common cancer in women, with an estimated 604,000 new cases appearing in 2020. According to the WHO, of the 342,000 global deaths in 2020, about 90% occur in Low and Middle Income countries (LMIC). 

The tragic aspect of cervical cancer is that it is largely preventable. We estimate that more than 95% of cervical cancer cases are a result of a Human Papillomavirus (HPV) infection, which is typically transmitted through sex. HPV is a group of more than 150 related viruses, although HPV 16 and HPV-18 are largely associated with increased risk of cervical cancer.  A HPV vaccine exists to protect against most types of HPV that are linked with cancer. However, the vaccine should be administered at a young age (between 9 to 12 years old)and up to 26 years old at the latest. 

Unfortunately, less than 30% of LMIC have introduced HPV vaccination and less than 3% of adolescents are vaccinated against HPV. The combination with low cervical cancer screenings means that many women do not find out about their HPV-related cervical cancer until it is too late, leading to hundreds of thousands of preventable deaths. According to the WHO, by 2030 it will kill more than 443,000 women per year in the world if no concrete action is taken urgently. 98% of these deaths will occur in developing countries, with 90% of them in sub-Saharan Africa.

Cervical cancer is indicative of health inequalities and gender inequalities. Its burden rests solely on women and girls. Globally it is the 4th most common cancer in women, despite being largely preventable in the first place. With vaccinations and screenings, more than 340,000 deaths could be prevented every year. 

Doctors of the World approach to addressing cervical cancer

At Doctors of the World (DotW), one of our top priorities in our programs on Sexual and Reproductive Health and Rights, is addressing cervical cancer. Around the world, DotW is mobilizing for better access to vaccinations, screenings, and treatment through advocacy and program development. We have particularly focused on addressing cervical cancer in Burkina Faso and Côte d’Ivoire, where we work with local health structures – in carrying out various projects to improve the management of HPV and cervical cancer. In Burkina Faso, we have screened more than 10,000 women since 2019 and around a hundred health professionals have been trained. 

In October 2022, DotW attended the annual conference of the Union for the International Fight against Cancer in Geneva in order to raise awareness of cancer of the cervix among key players. At this conference, DotW shared its recommendations for the fight against cervical cancer: 

• Promoting HPV screening tests by adopting a community approach,
• The promotion of self-sampling, which allows both to offer a wider choice of sampling techniques to patients for empowerment purposes, and to increase screening coverage in areas far from centers health,
• Promoting HIV testing for all women who test positive for HPV. Our first results suggest that HPV positive women are much more likely to be HIV positive. By identifying these women, HPV screening therefore also becomes a tool in the fight against the HIV epidemic.

Photography: 

Charly Kodjo