WHO | Cervical cancer 2/5/18, 1(26 PM

Cancer
Cervical cancer
Cervical cancer is the fourth most frequent cancer in women with an
estimated 530,000 new cases in 2012 representing 7.9% of all female
cancers. Approximately 90% the 270,000 deaths from cervical cancer in
2015 occurred in low- and middle-income countries. The high mortality
rate from cervical cancer globally could be reduced through a
comprehensive approach that includes prevention, early diagnosis,
effective screening and treatment programmes. There are currently
vaccines that protect against common cancer-causing types of human
papilloma virus and can significantly reduce the risk of cervical cancer.

Early diagnosis

Particularly in countries where screening programmes are not available,

diagnosing cervical cancer at an early stage and providing access to
effective treatment can significantly improve the likelihood of survival.
Currently, in many low resource settings, the disease is often not
identified until it is further advanced or treatment is inaccessible resulting
in a higher rate of death from cervical cancer. Understanding and
detecting symptoms of cervical cancer can assist with early diagnosis.

Symptoms of cervical cancer tend may include: irregular, intermenstrual

(between periods) or abnormal vaginal bleeding after sexual intercourse;
back, leg or pelvic pain; fatigue, weight loss, loss of appetite; vaginal
discomfort or odourous discharge; and a single swollen leg. More severe
symptoms may arise at advanced stages. WHO Package of essential
noncommunicable (PEN) disease interventions for primary health care in
low-resource settings has guidance on the approach to assessment and
referral for women with suspected cervical cancer in the primary care
setting.

Screening

Screening aims to detect precancerous changes, which, if not treated,

may lead to cancer. Women who are found to have abnormalities on
screening need follow-up, diagnosis and treatment, in order to prevent
the development of cancer or to treat cancer at an early stage.

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WHO has reviewed the evidence regarding the possible modalities to

screen for cervical cancer and has concluded that:

screening should be performed at least once for every woman in the

target age group (30-49 years) when it is most beneficial;
HPV testing, cytology and visual inspection with acetic acid (VIA) are
all recommended screening tests;
cryotherapy or loop electrosurgical excision procedure (LEEP) can
provide effective and appropriate treatment for the majority of women
who screen positive for cervical pre-cancer;
“screen-and-treat” and “screen, diagnose and treat” are both valuable
approaches.

Regardless of the approach used, the key to an effective programme is

to reach the largest proportion of women at risk with quality screening
and treatment. Organized screening programmes designed to reach
most women at risk are preferable to opportunistic screening.

Comprehensive approach to cervical cancer

WHO recommends a comprehensive approach to cervical cancer

prevention and control that includes multi-disciplinary interventions
across the life course. Community education, social mobilization,
vaccination, screening, treatment and palliative care are needed to
improve cervical cancer control. Almost all of cervical cancer deaths
could be avoided if known effective interventions were available to all
women and implemented, including immunizing adolescent girls against
human papilloma virus (HPV) and cervical screening and treatment of
pre-cancerous lesions.

To build on what exists and enhance progress, 7 UN agencies under the

United Nations Task Force on NCDs have established a Joint
Programme to prevent and control cervical cancer to provide global
leadership and technical assistance to support governments and the
partners build and sustain programmes.

WHO Related links

Global joint programme on cervical cancer

pdf, 466kb
HPV and cervical cancer fact sheet
WHO PEN Protocol 4.2 Assessment and referral of women with
suspected cervical cancer at primary health care
pdf, 34kb
Comprehensive cervical cancer control: a guide to essential practice
IARC resources on cervical cancer screening

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Related links

European guidelines for quality

assurance in cervical cancer
screening

http://www.who.int/cancer/prevention/diagnosis-screening/cervical-cancer/en/ Page 3 of 3