World Health Organization call for action to eliminate cervical cancer globally

Gültekin, Murat; Ramírez, Pedro T.; Broutet, Nathalie; Hutubessy, Raymond

doi:10.1136/ijgc-2020-001285

Cited by 143 publications

(108 citation statements)

References 6 publications

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“…The incidence of cervical cancer in Zambia is 66.4 per 100,000 women (4). Compared to the global average of 13.1 per 100,000 women (1), the World Health Organization's (WHO) goal to keep cervical cancer incidence below 4 in 100,000 may seem unattainable in Zambia (5). However, cervical cancer is, in fact, largely preventable.…”

Section: The Global and National Distribution Of Cervical Cancermentioning

confidence: 99%

“…Addressing the burden of cervical cancer is currently high on the national and international health agendas. The WHO (2013) has called for a 25% relative reduction of global non-communicable disease mortality by 2025 and the elimination of cervical cancer (5). The HPV vaccine has been identi ed as one of their cost-effective "best buy" interventions in helping to achieve these goals (19).…”

Section: Cervical Cancer On the Global And National Health Agendasmentioning

confidence: 99%

“…A uniting element of these national and international calls for addressing the burden of cervical cancer has been the emphasis on strengthening collective efforts with key stakeholders and community members to improve prevention strategies (2,5,9). The low vaccination rates are problematic in the face of Zambia's high rates of cervical cancer.…”

Section: Cervical Cancer On the Global And National Health Agendasmentioning

confidence: 99%

“…The low vaccination rates are problematic in the face of Zambia's high rates of cervical cancer. Addressing this large and complex burden of disease will require innovative interventions which engage with communities to better understand the contextual barriers limiting their uptake of the HPV vaccine in girls (5,20).…”

Section: Cervical Cancer On the Global And National Health Agendasmentioning

confidence: 99%

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Community groups to increase Human papillomavirus (HPV) vaccination through Participatory Learning and Action, Reducing barriers and increasing community Mobilisation in Zambia (CHARMZ) project.

Hoernke¹

2020

Preprint

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Background Zambia has a high incidence of cervical cancer. Uptake of the human papillomavirus (HPV) vaccine has been low since it first became available in Zambia in 2013. Community mobilisation and engagement with civil society has been identified as a key component of HPV vaccination programs in low and middle-income countries. Of the evidence available on community-based interventions in the context of HPV, participatory approaches which work closely with local stakeholders to identify and overcome barriers to HPV vaccination uptake have shown promising results. This is a proposal for a community-based cluster randomised controlled trial to increase HPV vaccination uptake in Zambia through a participatory learning and action (PLA) cycle approach in community groups. PLA is an approach in which participants identify and prioritise problems, and subsequently develop, implement and evaluate solutions to improve the health needs of their community. Key stakeholders to be engaged in this project include government members, policymakers, healthcare, donors and relevant non-governmental organisations (NGO), religious leaders, and civil society members. Formative research will be carried out with key stakeholders through semi-structured interviews and focus group discussions. The community group intervention will be facilitated by local healthcare workers from the cervical cancer prevention program in Zambia (CCPPZ).Results Success will be indicated by an increase in HPV vaccination uptake. The primary outcome will be HPV vaccination rates measured quantitatively. Data will be gathered once at the start of the study, once midway through the PLA phase and once during the post-intervention phase. Questionnaires and semi-structured interviews will allow for measurement of secondary outcomes both quantitatively and qualitatively, including perceived (i) HPV vaccination and cervical cancer knowledge, (ii) acceptability, accessibility and equitability of the HPV vaccination, as well as (iii) attitudes of female group members towards other cervical cancer screening and treatment services.Conclusions There is a need to address the high cervical cancer disease burden in Zambia. This would be the first intervention aiming to increase HPV vaccination uptake in Zambia through a low-cost, sustainable and scalable community-based participatory learning and action cycle approach.

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Section: The Global and National Distribution Of Cervical Cancermentioning

confidence: 99%

Section: Cervical Cancer On the Global And National Health Agendasmentioning

confidence: 99%

Section: Cervical Cancer On the Global And National Health Agendasmentioning

confidence: 99%

Section: Cervical Cancer On the Global And National Health Agendasmentioning

confidence: 99%

See 2 more Smart Citations

Community groups to increase Human papillomavirus (HPV) vaccination through Participatory Learning and Action, Reducing barriers and increasing community Mobilisation in Zambia (CHARMZ) project.

Hoernke¹

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…1 Women in low-and middle-income countries (LMICs) are highly vulnerable to cervical cancer, with around 90% of cases and deaths from cervical cancer occurring in LMICs. 2 Infection with the human papillomavirus (HPV)-which is spread through sexual contact-plays a principal role in the development of nearly all cases of cervical cancer. 1 3 4 Of the different types, HPV 16 and 18 are responsible for more than 70% of cervical cancer cases, followed by other strains of HPV.…”

Section: Gynecological Cancermentioning

confidence: 99%

Effective approaches towards eliminating cervical cancer from low-and middle-income countries amid COVID-19 pandemic

Rahman

Gültekin

Lassi

2020

International Journal of Gynecological Cancer

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Cervical Cancer Screening

Perkins

Wentzensen

Guido

et al. 2023

JAMA

128

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ImportanceEach year in the US, approximately 100 000 people are treated for cervical precancer, 14 000 people are diagnosed with cervical cancer, and 4000 die of cervical cancer.ObservationsEssentially all cervical cancers worldwide are caused by persistent infections with one of 13 carcinogenic human papillomavirus (HPV) genotypes: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. HPV vaccination at ages 9 through 12 years will likely prevent more than 90% of cervical precancers and cancers. In people with a cervix aged 21 through 65 years, cervical cancer is prevented by screening for and treating cervical precancer, defined as high-grade squamous intraepithelial lesions of the cervix. High-grade lesions can progress to cervical cancer if not treated. Cervicovaginal HPV testing is 90% sensitive for detecting precancer. In the general population, the risk of precancer is less than 0.15% over 5 years following a negative HPV test result. Among people with a positive HPV test result, a combination of HPV genotyping and cervical cytology (Papanicolaou testing) can identify the risk of precancer. For people with current precancer risks of less than 4%, repeat HPV testing is recommended in 1, 3, or 5 years depending on 5-year precancer risk. For people with current precancer risks of 4% through 24%, such as those with low-grade cytology test results (atypical squamous cells of undetermined significance [ASC-US] or low-grade squamous intraepithelial lesion [LSIL]) and a positive HPV test of unknown duration, colposcopy is recommended. For patients with precancer risks of less than 25% (eg, cervical intraepithelial neoplasia grade 1 [CIN1] or histologic LSIL), treatment-related adverse effects, including possible association with preterm labor, can be reduced by repeating colposcopy to monitor for precancer and avoiding excisional treatment. For patients with current precancer risks of 25% through 59% (eg, high-grade cytology results of ASC cannot exclude high-grade lesion [ASC-H] or high-grade squamous intraepithelial lesion [HSIL] with positive HPV test results), management consists of colposcopy with biopsy or excisional treatment. For those with current precancer risks of 60% or more, such as patients with HPV-16–positive HSIL, proceeding directly to excisional treatment is preferred, but performing a colposcopy first to confirm the need for excisional treatment is acceptable. Clinical decision support tools can facilitate correct management.Conclusions and RelevanceApproximately 100 000 people are treated for cervical precancer each year in the US to prevent cervical cancer. People with a cervix should be screened with HPV testing, and if HPV-positive, genotyping and cytology testing should be performed to assess the risk of cervical precancer and determine the need for colposcopy or treatment. HPV vaccination in adolescence will likely prevent more than 90% of cervical precancers and cancers.

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World Health Organization call for action to eliminate cervical cancer globally

Cited by 143 publications

References 6 publications

Community groups to increase Human papillomavirus (HPV) vaccination through Participatory Learning and Action, Reducing barriers and increasing community Mobilisation in Zambia (CHARMZ) project.

Community groups to increase Human papillomavirus (HPV) vaccination through Participatory Learning and Action, Reducing barriers and increasing community Mobilisation in Zambia (CHARMZ) project.

Effective approaches towards eliminating cervical cancer from low-and middle-income countries amid COVID-19 pandemic

Cervical Cancer Screening

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