HPV vaccination for girls and boys
Approximately 70% of all cervical cancers are caused by two strains of human papillomavirus (HPV). The HPV vaccine protects against these strains, and greatly decreases the likelihood of developing cervical cancer. Universal HPV vaccination of all girls at age 12 years could avert 690,000 cases and 420,000 deaths worldwide over their lifetime.
Both boys and girls can and should be vaccinated against HPV. Vaccine coverage for both boys and girls must be increased to eliminate cervical cancer. Low- and middle-income countries (LMICs) need the most funding to implement vaccine programs, but they receive the least funding from domestic and international sources. Please refer to the World Health Organization’s vaccination guidelines.
Cervical cancer screening in adults
Cervical cancer screenings can identify precancerous lesions on the cervix before they develop into cancer. Visual inspection of the cervix with acetic acid (VIA) is cheap, effective, and can be done easily in resource-poor environments. Beyond VIA, cytological diagnostics, where available, have higher sensitivity and specificity.
Same-day treatment of precancerous lesions
Women should receive any necessary treatment during the same visit as their examination. Visiting a clinic is difficult for many women and they may not be able to return to the clinic soon after the first visit; clinics must offer same-day treatment to prevent loss to follow-up. This is the World Health Organization standard. Clinics must also offer referrals for the Loop Electrosurgical Excision Procedure (LEEP) and cancer care for those women who need it.
Innovation for more effective diagnostic and treatment tools
Visualization of the cervix is crucial to ensure that the patient receives appropriate care. New technologies like lenses that magnify cell phone camera images allow for better record-keeping and quality assurance.1 Huge advances in using artificial intelligence to identify precancerous lesions are coming in the very near future! Critical new low-cost, effective HPV diagnostic tests are also in development. Finally, we must push for the fast approval and scale-up of new thermal ablation devices for treatment.
Integration of cervical cancer prevention services into HIV/AIDS and reproductive health programs
Cervical cancer prevention is essential to preserving the gains that have been made in HIV/AIDS prevention and reproductive health. Women living with HIV develop cervical cancer at 5-6 times the rate of HIV-negative women. Screening and treatment of precancerous lesions is particularly important for HIV-positive women. When cervical cancer prevention and HIV/AIDS treatment are integrated, the proportions of both HIV-negative and -positive women who are screened for cervical cancer and HIV increases.
When cervical cancer prevention and reproductive health services are integrated, women tend to use more of both services during their visits to a provider. Additionally, there is significant evidence that cervical cancer prevention helps maintain gains in child mortality rates, as the health of a mother has profound effects on the health of her children.