Eliminating Deaths From Cervical Cancer—Report of a Panel at the 7th Annual Symposium on Global Cancer Research, a Satellite Meeting at the Consortium of Universities for Global Health 10th Annual Meeting

Abstract

This is a summary of the presentations addressing approaches and achievements to reach the goal of eliminating cervical cancer as a global public health problem that were delivered at the 7th Annual Symposium on Global Cancer Research at the 10th Annual Consortium of Universities for Global Health Meeting in March 2019. Dr Princess Nothemba Simelela, Assistant Director-General for Family, Women, Children and Adolescents, World Health Organization, gave an introduction to the World Health Organization–led Cervical Cancer Elimination Initiative and the emerging conceptual framework and targets that will shape the global 2020 to 2030 strategy. Subsequent presentations shared experiences from national programs in Rwanda (Agnes Binagwaho), Latin America (Patricia J. Garcia), and Senegal (Babacar Gueye and J. Andrew Dykens. Successes in intensified human papillomavirus vaccination and screening with follow-up treatment of early and advanced lesions detected are highlighted as well as the challenges and obstacles in achieving and maintaining high coverage in Africa and Latin America. With strong political leadership, commitment of national stakeholders, and the use of proven and cost-effective approaches to human papillomavirus vaccination, screening, and treatment, the vision of a world free of cervical cancer and saving women’s lives every year by preventing deaths from cervical cancer will be achievable in the next generation in all countries.

The Lancet Commission on diagnostics: transforming access to diagnostics

“…Obstetrician and gynaecologist professionals in some Latin American countries have vested interests in revenue from cytology (eg, Pap smears) and have resisted the shift to self-sampling for human papillomavirus molecular testing, which could be done instead by nurses and midwives. 109 The key message with regard to policy is the limited recognition of the central importance of diagnostics, which results in major underfunding and insufficient resources at all levels. There is a need for greatly increased, strong, continuing advocacy for diagnostics.…”

Safety and Acceptability of Thermal Ablation for Treatment of Human Papillomavirus Among Women Living With HIV in Western Kenya

“… 9 In Malawi, over a 5-year period, only 43.3% of women who screened VIA-positive accessed treatment owing to challenges with delivering cryotherapy. 10 To achieve the WHO’s cervical cancer elimination strategy, which includes targets of 70% of women screened for cervical cancer using an HPV test, and 90% of those with a positive result adequately treated by 2030, 11 accessible treatment options are an urgent priority.…”

Policy Considerations to Promote Equitable Cervical Cancer Screening and Treatment in Peru

“…Specifically, the technical document emphasized the importance of rotations for health providers and training in the technique of VIA, cryotherapy, and HPV testing, and the creation of a monitoring system for training facilities [ 39 ]. As noted elsewhere, political will and support is a key factor to implementing screening and treatment programs at scale [ 10 ].…”

“…• Modify policies to address insufficient organizational competencies Digital health tools and telemedicine have the potential to expand access to care in areas that lack adequate health system infrastructure, capacity, and human resources to provide prompt care. These solutions can support task-shifting activities or consultations with specialists to other health providers (e.g., midwives), an effective model for countries with limited resources [1,10,22,37]. Yet, reliance on cell phone technology will face additional challenges, such as connectivity to national mobile infrastructure and security of the devices in the health facilities.…”

“…It is common for a woman to wait a year between her first screening and the start of her treatment. Many women diagnosed with cervical cancer are indigenous and experience additional stigma, along with cultural and linguistic barriers, all of which exacerbate disparities in health outcomes [ 8 9 10 11 12 ]. In addition, hospitals are located at the edge of low-income communities without sufficient workforce or resources to provide high-quality care, and gaps in health insurance coverage result in unequal access to essential reproductive health services [ 13 ].…”