WHO strategy for cervical cancer elimination to save 62 million lives

  • Canfell K & al.
  • Lancet
  • 30 Jan 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • 90-70-90 WHO triple-intervention strategy for cervical cancer elimination will avert over 62 million deaths and cut mortality rate by 98.6% in lower-middle-income countries over the next century.
  • Mortality reduction could be seen by 2030 with successful scale-up.

Why this matters

  • A multisectoral and integrated approach is needed across the continuum of cancer care to achieve this outcome.

Study design

  • WHO 90-70-90 triple-intervention coverage targets for scale-up of HPV vaccination to 90%, twice-lifetime cervical screening to 70%, and treatment of preinvasive lesions and invasive cancer to 90% by 2030.
  • Study projected mortality rates over the next century assuming successful scale-up of girls-only HPV vaccination coverage, cervical screening, and precancer treatment in 78 LMICs compared with status quo.
  • Funding: WHO; others.

Key results

  • Projected mortality reductions and averted deaths by 2030 and 2120:
    • Vaccination+twice-lifetime screening+treatment:
      • Reduction in mortality: 34.2% and 98.6%.
      • Deaths averted: 1.3 million and 62.6 million deaths. 
    • Vaccination+once-lifetime screening+treatment:
      • Reduction in mortality: 34.3% and 97.9%.
      • Deaths averted: 0.3 million and 60.8 million deaths.
    • Vaccination alone:
      • Reduction in mortality: 0.1% and 89.5%.
      • Deaths averted: 620 and 45.8 million deaths.

Limitations

  • Intensive scale-up assumed.