The World Health Organization (WHO) has called for the elimination of cervical cancer, but progress has been slow. While high-income countries have made tremendous strides, the incidence and mortality rates in low- and middle-income countries are still too high. In a study published in the Lancet in July 2016, researchers from the Caribbean island nation of Jamaica found that cervical cancer deaths and incidence were similar in the two regions, while the rate of cancer among women was lower.
The findings indicate that high levels of mortality and late presentation of cervical cancer are associated with HIV/AIDS. While these factors are not always linked, they do support the use of HPV testing and vaccination in countries with low- and middle-income status. To improve cervical screening, governments must make the use of HPV tests and vaccines a central component of national health policies. It is also important that governments address the training and educational needs of both health workers and the broader population.
The global cervical cancer elimination strategy calls for governments and partners to work with communities and the private sector to improve screening and diagnostic services. By integrating cervical screening with reproductive health services and anti-retroviral therapy (ART), governments can streamline their workflows and make better use of their overstretched healthcare workforce. This is a win-win situation. When a nation achieves 90-70-90 cervical cancer targets by 2030, high socioeconomic benefits are expected. The cost of the study will be $10.5 billion.
Cervical cancer has the greatest burden in low- and middle-income countries, with ninety percent of deaths occurring in low and middle-income countries. While it’s true that cervical cancer is the most prevalent cancer in high-income nations, it’s not universally diagnosed in these countries. In low- and middle-income countries, screening and treatment rates are low and mortality rates are low, but cervical cancer deaths are also disproportionately high in these countries.
In low- and middle-income countries, effective cervical cancer prevention and treatment interventions must be available in every region. The availability of quality medicines, an adequate health workforce, and access to quality information are essential for the elimination of cervical cancer in these countries. However, low- and middle-income nations still face some challenges. Despite this, they can achieve significant gains by adopting a life-course approach to health.
Using a public-health approach and evidence-based interventions are the best way to tackle cervical cancer in low- and middle-income countries. The WHO secretariat modelled the socioeconomic and health impacts of 90-70-90 targets in 78 low- and middle-income countries by 2030. The study found that heterogeneity in cervical cancer incidence would continue to be a barrier to eliminating the disease in the future.
There are many challenges to implementing such interventions in low- and middle-income countries. First and foremost, low-income countries have the highest disease burden. In addition, the lack of quality healthcare and a lack of quality medicines will ultimately undermine any success in eliminating the disease. Second, a well-designed strategy will be essential to achieve the elimination of cervical cancer in low- and mid-income countries.
Third, targeting cervical cancer in low- and middle-income countries will require a high-quality health workforce. As cervical cancer becomes more common, a high-quality health workforce will be necessary. The availability of quality medicines will reduce the risk of death and ensure a healthy life expectancy. In addition, the right policy will help overcome the stigma associated with the disease. The best strategies should be patient-centric and targeted at the disease in low and middle-income nations.
The three-pillar intervention strategy of cervical cancer in low and middle-income nations will be more effective if it is designed to address the country’s health system’s weaknesses. While biomedical interventions will provide high-quality care, the low-income countries’ health systems will need the support of local communities to ensure the disease is screened. And a single-tier approach will only benefit a few countries, while a large number of low-income countries will require billions of dollars.
