WHO recommends a life-course approach to prevention and control of cervical cancer with age appropriate, cost-effective interventions that target the disease along the life course. These range from interventions that prevent infection with cancer causing HPV strains, to screening for precancer and early cancer to diagnosis, prompt treatment of cancer and palliative care.
Unlike other cancers, cervical cancer is almost 100% preventable by ensuring that young girls are vaccinated with HPV vaccines and women receive quality screening and treatment of precancerous lesions.
Primary prevention: vaccinations that protect against HPV-16 and HPV-18.
WHO recommends that adolescents, principally girls aged between nine and 14 get two doses of HPV vaccine to prevent infection with HPV, the second dose about six to 12 months after the first one. Studies have also shown adequate immune response in HIV-positive children to allow them to receive the HPV vaccine. Other preventive measures include culture and age appropriate adolescent sexual reproductive health education as well as male circumcision. It is also recommended to raise awareness and educate people about cervical cancer.
Secondary prevention: screening and treatment of precancerous lesions.
Today, especially in resource-poor settings such as most of Africa, cervical cancer is mostly diagnosed when the disease has progressed to advanced stages. WHO recommends screening for women aged 30 to 49 years. Recommended screening methods should be able to detect precancer and include HPV DNA testing, visual inspection with acetic acid (VIA) as well as Pap smear. These tests are simple to conduct in low-resource settings and the results can be available almost immediately, thus ensuring that women who test positive can be treated almost immediately. Although a woman need not be screened again for at least five years if she has screened negative for HPV, she must be rescreened within the next 10 years. However, in order to have the maximum impact in terms of reducing cervical cancer suffering and death, priority should be given to maximizing coverage and treatment rather than maximizing the number of screening tests in a woman’s lifetime. This is true for all women regardless of HIV status. It is important to ensure that every woman is screened at least once in her lifetime.
Cervical lesions, once confirmed, can be treated using a process that involves the removal of the abnormal cells in the cervix to prevent them from progressing to cancer.
Tertiary prevention: diagnosis and treatment of invasive cervical cancer.
Effective pathology services are required to be able to diagnose and stage cervical cancer. Depending on the type and stage of cervical cancer, patients may need more than one type of treatment. Treatment modalities include surgery or radiation combined with chemotherapy.