Health ministers commit to reducing cervical cancer, deaths by 30%

The ministers of health of the Region of the Americas agreed to implement a series of strategic actions to reduce new cases of cervical cancer and the resulting deaths by one-third in the region by 2030.

Thirty-five countries and territories of the Western Hemisphere last week adopted the Plan of Action for Cervical Cancer Prevention and Control 2018-2030, in the 56th Directing Council of the Pan American Health Organization (PAHO), in Washington, DC.

"No woman should die from cervical cancer, which can be prevented, detected at early stage, and treated effectively," said PAHO's director, Carissa F. Etienne. "Reducing the burden of cervical cancer is possible and the plan approved is an expression of the countries' pledge to accomplish this."

- Cancer is the second leading cause of death in the Americas.

- In 11 countries, cervical cancer is the leading cause of cancer deaths among women and in 12 countries it ranks second.

- Every year, an estimated 83,200 women are diagnosed and 35,680 women die from this disease in the region.

- 52 per cent of them before age 60.

By adopting the action plan, the countries have agreed to improve the effectiveness and organisation of cervical cancer programmes and information and record-keeping systems, and to strengthen primary pre-vention with the HPV vaccine and information/education campaigns.

They have also committed to implementing innovative strategies to improve cervical cancer screening and the treatment of precancerous lesions. Efforts will also be made to improve access to services for cancer diagnosis, treatment, rehabilitation, and palliative care.

Inequitable access to prevention, diagnosis, and treatment is a major challenge. Cervical cancer affects more indigenous women, people of African descent, and people living in less developed areas, as well those with lower socio-economic, educational, and income levels.

To reduce the burden of cervical cancer, the plan of action includes:

- A target of vaccinating more than 80 per cent of girls from nine to 14 years of age against human papillomavirus (HPV), the cause of cervical cancer.

- The plan also proposes to screen at least 70 per cent of women from 30 to 49 years of age and treat precancerous lesions in all women who need it.

"Only with community participation and the implementation of large-scale HPV vaccination programmes, in addition to cervical cancer screening services that are accessible to all women everywhere, can we accelerate the achievements, prevent new cases, and save lives," said Anselm Hennis, director of the Department of Noncommuni-cable Diseases and Mental Health at PAHO/WHO.

The HPV vaccine was first introduced in the region in 2006. Approximately 31 countries and territories in the Americas include this vaccine in their national immunisation programmes. However, vaccine coverage with the required two doses varies considerably from country to country and is generally lower than the ideal coverage needed for maximum effectiveness.

Cervical cancer screening is available in almost all the countries of the region, with Pap tests most commonly used. However, the HPV test, which is more effective, has only been adopted in nine countries. Expanding its use could improve effectiveness and coverage to reach the estimated 32 million women who need screening.

The plan of action establishes that detection by itself is not sufficient to prevent cervical cancer. It is essential to treat the women who need it. However, there are gaps in access to these services. Another challenge that the plan addresses is limited access to palliative care, which only 10 countries in the region report offering.