Inadequate Cervical Cancer Prevention Causes Thousands of Unnecessary Deaths

Inadequate Cervical Cancer Prevention Causes Thousands of Unnecessary Deaths

A series of articles highlights that a vast majority of deaths in cervical cancer occur in low- and middle-income countries, despite the fact that prevention measures would cost little in comparison with the price tag of treating the cancer.

Three articles focused on women’s cancers made up the series, which appeared in the latest issue of The Lancet;

“With many competing health priorities in low- and middle-income countries, services for women’s cancers are given low priority and allocated few resources,” Lynette Denny, a professor at Groote Schuur Hospital, University of Cape Town, South Africa, and the first author of one of the articles, said in a press release.

“But there are several low-cost, feasible interventions that do not require specialized care in hospital or massive capital investment, and which could be integrated into existing health-care programs,” Denny added.

The authors of the series underscore that interventions for women’s cancers in low- and middle-income countries have taken second seat, making the group of researchers call for international efforts to end preventable deaths from cervical and breast cancers.

Today, cervical cancer is almost totally preventable if girls are routinely vaccinated against human papillomavirus (HPV), and women are screened for precancerous changes. Both measures are cost-effective and do not require specialist centers or oncologists.

As part of the research, the teams estimated the number of women diagnosed with cervical cancer will rise by at least 25%, to more than 700,000, by 2030. A vast majority of these cases will be seen in low- and middle-income countries.

“There is a widespread misconception that breast and cervical cancers are too difficult and expensive to prevent and treat, particularly in resource-poor countries where the burden of these diseases is highest. But nothing could be further from the truth,” said Ophira Ginsburg, a professor at the University of Toronto, Canada, who was the series leader.

Cost assessments show that a basic packing for cancer prevention in low- and middle-income countries, could cost as little as $1.72 per person. This would amount to only 3% of current health spending in these countries.

With a low interest in women’s cancers among governments in low- and middle-income countries, the situation has been worsened by a continuing underinvestment in these countries, which receive only 5%  of global cancer funding. This lack of interest contributes not only to poor women’s health, but also slow economic development and contributes to poverty.

In high-income countries like Canada, the U.S., and the U.K. that employ cervical cancer screening, age-standardized cervical cancer rates are less than 7.9 per 100,000 women. In some countries in sub-Saharan Africa and Central America and South America, which rarely have organized screening, more than 40 per 100,000 women are diagnosed with cervical cancer.

Nevertheless, the studies showed that these differences are seen not only between the richest and poorest countries of the world. In Europe, analyses of breast cancer survival data showed that 20% fewer women survived the cancer in Lithuania compared to Sweden, where 86% of women survive past five years.

Researchers behind the series believe international efforts to achieve universal health coverage to put an end to unnecessary cancer cases and deaths by 2030. They also noted that women’s cancers, which kill nearly three times as many women per year as pregnancy and childbirth complications, may prevent countries from reaching the UN’s Sustainable Development Goal.

They further argue that the key to reaching a good level of prevention is to invest in health systems, rather than to focus on disease-specific programs. Likewise, they argue that restructuring the flow of resources from international aid is needed, as the allocation of funds for non-transmittable diseases is disproportionately low.

“The global community cannot continue to ignore the problem — hundreds of thousands of women are dying unnecessarily every year, and the need for affordable access to cancer care is projected to increase in the coming decades, as many of the poorest countries face rising rates of cancers,” said Richard Sullivan, professor of Cancer and Global Health at King’s College London.

“This situation could be turned around by 2030 if the international community, policymakers, politicians, healthcare professionals and patients address this issue now,” he said.

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