Progress towards eliminating cervical cancer among women living with HIV

Major progress is currently occurring on all fronts, two years after the launch of the “Global strategy to accelerate the elimination of cervical cancer,” and documentation of the higher risk for cervical cancer that women living with HIV.

The number of women living with HIV, who underwent a screening for cervical cancer, has exceeded 1.9 million in no less than 19 countries. About 53 countries have either modified their policies to incorporate WHO’s recommendations or aim to do so within three years, in response to WHO’s latest guidelines on screening and treatment to prevent cervical cancer.

Countries, partners, implementers, funders, and civil society, have all been prompted by “The Cervical Cancer Elimination Initiative” to instantly take up cervical cancer prevention and treatment. Director of WHO’s Global HIV, Hepatitis and STIs Programmes, Dr Meg Doherty, said “It is a true global effort and the results in these few years are impressive. This commitment to saving women’s lives must continue.”

However, further measures must be taken. According to the previously published results of “impact of HIV on cervical cancer in South Africa,” we can completely end cervical cancer, notwithstanding the constant spread of HIV.  A substantial decline in the age-standardized occurrence of cervical cancer over time, was foreseen by three independent models, as a result of following WHO’s elimination strategy for vaccination, 2 lifetime cervical screens and high treatment coverage. Within the first 25 years, we avoided roughly one third of cumulative cervical cancer cases among women living with HIV and women overall.

Nevertheless, the prevention of cervical cancer for women living with HIV will be a much harder goal to achieve. Even after surpassing an impressive 85% reduction in the occurrence rate of cervical cancer, the elimination margin of less than four cases per 100 000 woman-years was barely reached, after regularly screening women living with HIV, precisely every three years.

The WHO’s guideline for screening and treatment for cervical cancer prevention, strongly recommended a more frequent screening of women living with HIV, along with spreading the awareness on safe and effective human papillomavirus vaccination.

Countries with higher HIV rate, are typically more subjected to cervical cancer, and thus in more need to increase their efforts towards achieving elimination.