Improving access to cervical cancer treatment for women with HIV

Improving access to cervical cancer treatment for women with HIV
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According to the World Health Organisation (WHO), progress is being made in the provision of cervical cancer treatment for women with HIV across the world.  

This comes two years after WHO launched their global strategy to accelerate the elimination of cervical cancer. It is estimated that over 1.9 million women living with HIV were screened for cervical cancer across 19 different countries in 2021, providing important access to cervical cancer treatment.  

An additional 53 countries have either updated their policies in response to WHO’s guidelines on screening and cervical cancer treatment or plan to do so in the next 3 years.  

What is cervical cancer?

Cervical cancer refers to any cancer found anywhere in the cervix, which is part of the female reproductive system. Nearly all cervical cancers are caused by an infection from certain types of human papillomavirus, such as HIV. 

Cervical cancer can be prevented by attending cervical screenings, which aim to find and treat changes to cells before they turn into cancer. Cervical cancer usually grows very slowly, and the severity of the disease often depends on how big it is, and the general health of the patient.  

“The Cervical Cancer Elimination Initiative has motivated countries, partners, implementers, funders, and civil society to accelerate access and uptake of cervical cancer treatment and prevention. It is a truly global effort and the results in these few years are impressive. This commitment to saving women’s lives must continue,” said Dr Meg Doherty, Director of WHO’s Global HIV, Hepatitis and STIs Programmes 

There is still progress to be made according to WHO. Results published on the impact of HIV on cervical cancer in South Africa have shown that cervical cancer can be eliminated, even in a high-burden setting. WHO have used three independent models to predict a substantial decline in incidents of age-standardised cervical cancer if the WHO guidelines were followed. Approximately one-third of cumulative cervical cancer cases among both women living with and without HIV were averted over the first 25 years. 

Many countries still need improved access to cervical cancer treatment

However, reaching the point of elimination for cervical cancer among the population of women living with HIV will be more challenging. Cases of cervical cancer incidents have declined by over 85% in recent years. The elimination threshold of under four cases per 100,000 years of life was only achieved when women living with HIV were screened more frequently (every three years).  

Expanding coverage of safe and effective human papillomavirus vaccination combined with a more frequent screening of women living with HIV, as recommended in WHO’s guidelines for screening and cervical cancer treatment prevention, will be necessary to eradicate the disease. 

The countries with the highest burden of HIV are often those with the highest incidence of cervical cancer, therefore these countries will have to make significant progress to reach elimination. These results show that it is possible to eradicate the disease and that there is a pathway to achieve it. 

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