Cervical cancer trends, HPV vaccine utilization, and screening in low- and lower-middle-income countries: an updated review
M. Hamid, Subeh Hasneen, A. Lima, Shandipon Roy Shawon, Mohammad Shahriar, Ramisa Anjum
Abstract
Cervical cancer is the fourth most common cancer among women worldwide, with 660,000 new cases and 350,000 deaths reported in 2022. This disease mainly affects women in low- and lower-middle-income countries (LMICs), where 90% of cases occur. This study explored how LMICs are responding to the World Health Organization's (WHO) call to eliminate cervical cancer. It looked at cervical cancer rates, the use of human papillomavirus (HPV) vaccines, and suggested strategies to fight the disease. The study analyzed the rates of cervical cancer and deaths in LMICs, the effectiveness of HPV vaccination programs, and how well screening efforts are working. To compare data across countries, it used age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs) per 100,000 women per year. In 2022, the ASIR was 25.4% in lower income countries and 16.9% in lower-middle-income countries. The ASMR was also higher in lower income countries (18.5%) compared to lower-middle-income countries (10.3%). HPV vaccine coverage remains low in many LMICs, with significant differences between the rates of first and final doses completed. By 2050, the number of new cervical cancer cases is expected to rise. Although the WHO aims to eliminate cervical cancer by achieving 90% HPV vaccination by age 15, 70% screening coverage, and 90% access to treatment, many challenges remain in LMICs. These include weak healthcare systems, poor infrastructure, and a lack of health education. Overcoming these challenges through better vaccine distribution, improved screening programs, and stronger healthcare systems is essential to eliminate cervical cancer.