Abstract

Every 2 minutes somewhere in the world a woman dies of cervical cancer a preventable disease. This cancer is caused by infection with a virus the human papillomavirus, HPV ; it is a cancer with detectable and treatable precancerous states and therefore one which can be effectively prevented by vaccination and screening. – Highly safe and effective vaccines that can prevent the majority of HPV infections that cause cervical and other HPV -associated cancers are available they are being implemented in many, mainly high income (HIC) countries and we know that they are hugely effective. – Tests for screening and detection and methods to treat cervical pre-cancerous lesions have been in place for decades in HIC and are proven to reduce cervical cancer incidence. – Combining HPV vaccination at high coverage for adolescents and high coverage of cervical screening, with appropriate treatment of all women, could eliminate cervical cancer as a public health problem. –Indeed recent modelling suggests that, with the tools available, elimination of cervical cancer in local populations is achievable within our lifetime. Certainly in the UK if the current coverage for HPV vaccination and screening is maintained cervical cancer could be eliminated in public health terms by 2050. But to achieve this globally, these primary and secondary interventions for prevention will need to be expanded, to include those not currently vaccinated or screened and this means women in low and middle income countries (LMIC). These are big challenges. Broad dissemination of HPV vaccines has been achieved in some low and high resource countries, but needs to be scaled up globally, to reach the majority of age eligible individuals. Strengthening of cervical cancer screening strategies in LMIC has proved hugely difficult in the past 2-3 decades and may be insuperable without economic development in the poorest regions. Vaccination with high enough coverage could in time make cervical cancer a disease of historic interest only, this is achievable but does require international collaboration and a collective will. Allowing women to rot to death from a preventable cancer should not be tolerated in the 21st century.