How We Can Eliminate Cervical Cancer: A Global Health Imperative

Cervical Cancer Can Be Prevented—So Why Are People Still Dying?

Cervical cancer is a disease of the past. It's one of the few cancers that can be prevented, detected early, and treated successfully. With the help of Human Papillomavirus (HPV) vaccines, successful screening tests, and early treatment, we possess all the tools we need to eliminate it.

But even with such advances, thousands of people continue to die annually, particularly in economically disadvantaged groups and low- and middle-income countries. Even in high-income nations such as the United States, there is still disparity in access and awareness—accounting for 11,500 new cervical cancer cases and 4,000 annual deaths.

A Three-Pronged Strategy to End Cervical Cancer

As Head of Global Health Policy at Roche Diagnostics, I fully support the World Health Organization's (WHO) cervical cancer elimination strategy, which requires:

1. HPV vaccination to prevent the disease at its source
2. Screening on a regular basis in women who are not vaccinated
3. Early treatment of people who are diagnosed with HPV or cervical cancer

We have a chance to turn the world back from cervical cancer—but we must act now to increase access, education, and innovation at every level of care.

The Access Gap: A Hurdle to Prevention

In poor-resource settings, limited finances, weak infrastructure, and restricted healthcare access put women far more at risk. But access problems are not limited to developing countries. In the United States, such barriers to access include:

1. Lack of awareness or misinformation
2. Transportation or childcare issues
3. Trauma in the past or cultural shame
4. Inconsistent healthcare provider recommendations
5. Segmented insurance and care delivery systems

These impediments prevent people from getting the life-saving screening and vaccination they need.

HPV Vaccination Rates Remain Too Low in the U.S.

Despite clear public health guidance for HPV vaccination from ages 9 to 26 (to age 45), the rate of uptake is alarmingly low. Adults and parents are unaware that HPV causes greater than 90% of all cervical cancers and that vaccination may be a prevention method.

To reverse this trend, we will need to:

1. Build trust in HPV vaccine safety and effectiveness
2. Integrate education into pediatric visits and school lessons
3. Provide vaccines in cities and the countryside

Why Screening Still Makes a Difference—Even with Vaccines

While vaccination will reduce future cases, screening remains indispensable in unvaccinated women. But the majority of cervical cancers occur in those who are never screened or screened too infrequently.

Two Forms of Screening:

1. Pap smears look for abnormal cervical cells
2. HPV tests detect the virus responsible for those abnormalities (16 and 18 are the most risky)

HPV testing is more precise and can be administered more flexibly, even via self-collection methods.

HPV Self-Collection: The Key to Reaching Hard-to-Reach Populations

Routine cervical screening relies on clinic availability, provider availability, and often invasive testing. But suppose women could collect their own samples in private?

They can—and they do.

A 2024 GlobalWebIndex (GWI) survey by Roche found that over 70% of women in 12 countries said they would opt for self-collection if offered.

Global Success Stories:

Australia: Self-collection increased HPV test rates, even in rural and remote communities

Peru: Among remote communities, 80% of women adopted self-collection screening

This approach transcends logistical, cultural, and emotional barriers—and holds promise to be a game-changer in increasing screening rates in the U.S. and around the globe.

Policy and Practice: What Must Shift?

To eradicate cervical cancer, healthcare systems must shift to meet people where they're at—literally and spiritually. The following four steps are crucial to take:

1. Educate and Raise Awareness

Only a few know about the link between HPV and cervical cancer. Public health messages must bridge this knowledge gap and merely state the advantages of HPV vaccination and screening.

2. Empower Healthcare Providers

Self-collection must be easy to integrate into clinical care. Policymakers and administrators must assist clinicians in offering flexible screening options that reduce the length of appointments and enhance follow-through.

3. Tackle All Barriers—Not Just Cost Ones

Even with insurance, there are too many Americans facing non-financial barriers to access—transportation, child care, lost time from work, and even emotional discomfort. These must be addressed in access plans.

4. Cultivating New Models of Care

The COVID-19 pandemic illustrated the way telehealth and home testing can expand access and reduce costs. HPV self-collection, mobile health clinics, and digital health technologies need to become an integral part of preventive care.

The Way Ahead: A Global Opportunity

Cervical cancer doesn't need to be a killer. We have the science, tools, and momentum to eradicate it. If only we work together across the public and private sectors to:

1. Make equitable access a top priority
2. Enable women to own their health
3. Streamline for providers to provide care
4. Transform how we screen and vaccinate

In so doing, we can ensure that nobody will die from an preventable cancer. Let's flip access, education, and delivery on its head—so that cervical cancer can be a thing of the past.