Chapter 4: Cervical Cancer
2015
This chapter focuses on the possibility of primary prevention of cervical cancer as a result of the introduction of two commercially available vaccines against human papillomavirus (HPV). Few low- and middle-income countries (LMICs) have initiated or sustained cytology-based cervical cancer prevention programs, and these countries experience very high incidence and mortality rates. Fortunately, alternative strategies to prevent cervical cancer have been investigated and extensively evaluated in these settings.
The authors report findings from cost-effectiveness analyses indicate promising opportunities to prevent cervical cancer in different world settings: HPV vaccination for preadolescent girls and screening of adult women, even only three times per lifetime, can avert a significant proportion of cervical cancer cases in a cost-effective manner. Other avenues for cervical cancer prevention include the use of alternative screening tests and strategies, namely HPV DNA testing and VIA. Both tests have their advantages and disadvantages, but the development of a highly reproducible, reliable, and accurate point-of-care HPV DNA test (or an alternative test yet to be developed but fulfilling these criteria) will enable women to be screened and treated in one visit and without the need for colposcopy and laboratory infrastructure.
Source:
Denny L, Herrero R, Levin C, Kim JJ. Chapter 4: Cervical Cancer. Gelband H, Prabhat J, Sankaranarayanan R, Horton S, eds. Disease Control Priorities, Third Edition: Volume 3. Cancer 2015. http://dcp-3.org/chapter/1296/cervical-cancer