New WHO Screening Guidelines Can Slash Cervical Cancer Death Rates by 63%
Cervical cancer death rates in low-to-middle-income countries could be significantly reduced by more than 63% through the implementation of updated screening guidelines from the World Health Organization (WHO), according to two groundbreaking studies.
The studies, published in Nature Medicine, were conducted by researchers at the Daffodil Centre, a collaboration between Cancer Council New South Wales and the University of Sydney. The first study focused on screening for human papillomavirus (HPV) in the general population in 78 countries, while the second study examined multiple screening scenarios for women with human immunodeficiency virus (HIV).
In 2021, the WHO released new guidelines recommending an HPV DNA-based test as the preferred screening method. This method surpasses visual inspection with acetic acid (VIA) or cytology (commonly known as a ‘Pap smear’), which are the most commonly used screening methods worldwide for detecting pre-cancer lesions.
HPV-DNA testing detects the presence of high-risk strains of HPV. Unlike visual inspection methods, HPV-DNA testing provides an objective diagnosis by eliminating the need for result interpretation.
Since HPV is responsible for almost all cervical cancers, switching from Pap tests to HPV screening in low-and-middle-income countries could significantly reduce mortality rates through earlier intervention, explained Dr. Kate Simms, lead author of the first study.
Low-and-middle-income countries shoulder most of the world’s cervical cancer burden. Therefore, demonstrating the effectiveness of HPV-based screening compared to other approaches is crucial in advocating for the WHO’s strategy and guidelines, said Dr. Simms.
The first study found that primary HPV screening was not only the most clinically effective but also the most cost-effective, reducing mortality by 63-67% when offered every five years.
Dr. Michaelia Hall, lead author of the second study, highlighted the heightened risk of cervical cancer faced by women with HIV compared to the general population. The study specifically focused on Tanzania, a country with one of the highest HIV infection rates globally. Dr. Hall’s research revealed that co-existing HIV and HPV infections were more prevalent in low-to-middle-income countries.
We modeled several scenarios in relation to outcomes in Tanzania and found that primary HPV testing with triage, when compared to no screening, could reduce cervical cancer mortality by up to 71%, Dr. Hall explained.
This would mean saving a life for every 38 women screened and referred for pre-cancer treatment—a remarkable result in terms of the benefits of cancer screening.
The updated WHO screening guidelines offer a concrete pathway to reduce cervical cancer deaths in low-to-middle-income countries. By implementing primary HPV screening, mortality rates can be significantly diminished, providing potentially lifesaving interventions for countless women.
The impact of these findings cannot be overstated, particularly for countries bearing the brunt of the cervical cancer burden. By adopting these evidence-based guidelines, healthcare systems can make substantial progress in the fight against cervical cancer.
It is now crucial for policymakers, healthcare providers, and communities to work together to ensure the successful implementation and accessibility of the updated screening guidelines. With the potential to save thousands of lives, adhering to these guidelines is a major step forward in the global battle against cervical cancer.
By prioritizing these screening methods and utilizing the sophisticated technology available, we can turn the tide against cervical cancer in resource-constrained settings. The WHO’s revised guidelines provide a beacon of hope, presenting new possibilities for preventing unnecessary suffering and loss of life due to this highly preventable disease.
