By Professor Albert Singer
Cervical cancer is the leading cause of cancer deaths in women in more than 40 countries. The prospect of cervical cancer becoming a rare disease is one of the most exciting things after having spent more than 50 years treating and counselling women whose lives and families have been torn apart by this dreadful illness. It is a remarkable proposition that cervical cancer could be virtually eliminated down to measurable global targets set by WHO.
However, what is most distressing is that a future without cervical cancer is never going to be a reality for many millions of women in the less-developed regions of the world. Despite the best efforts of the most talented scientists and physicians, they, their families and their communities will continue to be devastated by this almost entirely preventable disease.
Around 90% of all cervical cancer deaths occur in low- to middle-income countries
The systemic inequities within and between developing and developed countries must become less rather than more. Governments, clinicians, charities, foundations, pharmaceutical researchers must work to manage the socioeconomic costs of the pandemic that threaten to widen inequalities and shatter women’s prospects for good health and economic wellbeing. Prioritising the health of women and girls (World Bank blog) is one of the best investments for sustainable development (Kemme et al., in the BMJ): “Programmes that improve women’s health could have substantial and disproportionately higher economic and social returns, compared with other uses of social resources”.
Present tests, especially for HPV, – conducted by medical professionals in a clinic or by women in a setting of their choice – detect the precancerous stages and prevent their progression to cancer. We could see the eventual elimination of this cancer. However, we have to work harder to vaccinate as many and as widely as we can, particularly in the developing world, at the same time as increasing the rates of smear and HPV testing.
It is encouraging that medical practitioners in low, lower and middle income countries are learning about the normal and abnormal cervix and colposcopy from my online courses and I am proud that we offer the courses at significant discounts to many and at no cost to some.
Knowing about the risk factors, symptoms (or lack of) and common misperceptions of cervical cancer, and being able to identify early signs, are critical to helping prevent and detect it early. Early detection and timely treatment prevents up to 80% of cervical cancers in high income countries. The health services available to women differs greatly around the world, but the more nurses and doctors know, the more they can encourage prevention, screening and treatment in their communities. This education also equips them better to push for greater equitable access to screening, and if possible, vaccination programmes.
I have spent more than 5 decades fighting for better prevention, detection and treatment of cervical cancer. There is a realistic prospect that cervical cancer can be virtually eliminated; what will you do to help make that a reality?
Spotlight on Cervical Cancer, World Cancer Day information, 4 February 2020
Turning the tide: The fight to reclaim gains and accelerate progress for women and children, World Bank Blog, 7 November 2020
Investing in the health of girls and women: a best buy for sustainable development, British Medical Journal, 2 June 2020
A cervical cancer-free future: First-ever global commitment to eliminate a cancer, World Health Organisation, 17 November 2020