Cervical Cancer Leads Cancer Deaths for Women in 37 Countries
Cervical cancer is 100% preventable. Yet, ACS global cancer reports say every year 350,000 women globally die from the disease.
Differences in Cervical Cancer Incidence Rates Worldwide, 2022
Countries in red on this global map, most in sub-Saharan Africa, had the highest incidence rates for cervical cancer in 2022. The United States (dark blue), with 6 cases of cervical cancer for every 100,000 women, is among the countries with the lowest incidence rate. Other dark blue countries with low incidence were Australia, New Zealand, and eastern Mediterranean countries.
Cervical cancer is preventable when women receive the Human Papillomavirus (HPV) vaccine and recommended screening. Since the 1950s, the death rate from cervical cancer has decreased by as much as 70%, but those decreases are primarily in high-income countries.
Worldwide, cervical cancer is the 4th most common cancer in terms of both incidence and mortality in women. Yet, in 25 countries, cervical cancer is the #1 most common type of cancer in women. Eswatini, a tiny country on the northeast tip of South Africa has the highest rate with 96 cases out of every 100,000 women.
The countries with high incidence tend to have medium or low income. In fact, about 90% of new cervical cancer cases and deaths worldwide in 2020 occurred in low- and middle-income countries.
Cervical cancer is the #1 cause of death from cancer in women in 37 countries, with 29 of those countries in sub-Saharan Africa and the rest in Central and South America.
These statistics are according to the most recent American Cancer Society (ACS) Global Cancer Facts & Figures 5th Edition based on 2022 estimates from the International Agency for Research on Cancer (IARC). ACS researchers Hyuna Sung, PhD, Chexi Jiang, MPH, Rebecca Siegel, MPH, and Ahmedin Jemal, DMV, PhD, contributed to the report. An accompanying article from a collaboration with IARC researchers, “Global Cancer Statistics, 2022,” was published in the ACS flagship journal CA: Cancer Journal for Clinicians.
Most countries aren’t on track to meet the World Health Organization’s (WHO) Cervical Cancer Elimination target to end cervical cancer by 2030.
Infection with the human papillomavirus (HPV) causes nearly 100% of cervical cancers. The WHO’s initiative for 2030 calls for 90-70-90 targets, meaning before then:
- 90% of women worldwide are to be vaccinated against the HPV virus by age 15
- 70% of women worldwide are to be screened at age 35 and and again at age 45 (in 2019—only 71 countries had achieved this)
- 90% of women worldwide are to receive treatment when precancerous areas are found or when they’re diagnosed with cervical cancer
Unfortunately, not many countries are on track to meet the WHO goals. By 2030, the WHO goal is to get incidence rates of cervical cancer to below 4 for every group of 100,000 women.
Incidence rates remain the highest in these African regions and countries:
- Eastern Africa (40 women out of every 100,000 women)
- Parts of sub-Saharan Africa:
- Zimbabwe (68 women out of every 100,000)
- Malawi (71 women out of every 100,000)
- Zambia (72 women out of every 100,000)
- Eswatini (96 women out of every 100,000)
Countries’ uneven adoption of prevention measures such as HPV vaccines or cervical cancer screening, or both, has led to substantial inequality in cervical cancer incidence and death rates across the world.
The HPV vaccine is unevenly distributed across the globe, but improvements in vaccination for women in sub-Saharan Africa and south-eastern Asia are on the horizon.
Less than 1 in 6 (15%) eligible girls across the world have been vaccinated with full doses against HPV. That’s because as of 2020, only 2 in 6 girls (30%) lived in countries with access to the vaccine—even though 107 of the 194 WHO member countries have HPV vaccination as part of their national immunization programs.
The low global coverage of HPV vaccination is because most of the 10 countries with the highest populations (including China, India, Indonesia, and Russia) have not introduced the HPV vaccine nationally. India accounts for 20% of the global cancer burden due to HPV infection, and 84% of those HPV cases lead to cervical cancer.
In 2022, the WHO immunization advisory group publicized that a 1-dose HPV vaccine is as effective as 2-dose one.
In 2025, Nigeria and Bangladesh—2 of the 10 most-populated countries—will start implementing a single-dose HPV vaccination campaign, which has the potential to help prevent cervical cancer in about 26 million girls.”
Cervical cancer screening tests aren’t universally available, but new self-sampling options may improve screening rates.
Only 36% of women worldwide have been screened for cervical cancer, with substantial disparities in screening prevalence across countries. For instance, as of 2021, 63 of 202 countries did not have official recommendations for who should be screened for cervical cancer, when screening should start, and how frequently it should be repeated. See ACS cervical cancer screening guidelines.
The US isn’t free of screening issues. In the US, 20% to 50% of women diagnosed with cervical cancer were not screened during the 5 years before the diagnosis.
One approach that might help countries get in step with the WHO’s goal of having 70% of women screened at ages 35 and 45 is to offer women the supplies for self-sampling. The process involves a kit with the supplies needed for a woman to collect samples of cells from the vagina/cervix. Self-sampling can be done by the woman at home or in a health facility by a health care provider. The woman or her provider sends the collected cells to a lab where they’re checked for HPV strains that lead to a high risk of developing cervical cancer.
Promising evidence supports the potential of a self-sampling approach for HPV testing to increase screening participation in under-screened and never-screened women."
The Pap test complements HPV testing to screen for cervical cancer. A Pap involves examining sample cells collected from the cervix for precancerous signs.
ACS has research-based programs to help improve HPV vaccination and cervical cancer screening in countries where the risk of developing or dying from cervical cancer is high.
The 5th Edition of Global Cancer Facts & Figures includes descriptions of ACS initiatives to help transition countries to evidence-based cervical cancer control practices.
The Global HPV Cancer Free programs work with in-country cancer organizations to increase HPV vaccination worldwide. The ACS website Prevent Global HPV Cancers is a digital platform that facilitates shared learning for organizations and agencies working towards increasing vaccination in higher-burden, lower-resourced communities—typically those with medium-and low-incomes.
The site Prevent Global HPV Cancers describes programs currently active in Colombia, Kenya, and India.
Colombia
Parent Intervention Research is based on a study that developed and tested the impact of messages designed to educate parents of girls ages 9 to 17 in Bogata on the value of having their daughters receive the HPV vaccination.
Colombia Action Guide (en Espanol)
India
Overcoming Barriers to HPV Vaccination Among Physicians in India, a research report by the Centre for Social and Behaviour Change in collaboration with the Cancer Foundation of India and support from the ACS Global HPV Cancer Free Initiative
HPV Vaccination and Cervical Cancer Screening Social Media Toolkit: India
Cervical Cancer Prevention through HPV Vaccination: An Action Guide for Medical Societies in India
Kenya
Parent Intervention Research, a summary of the first original behavioral research study by Busara Center for Behavioural Economics in partnership with Women 4 Cancer, Burness, and the American Cancer Society
HPV Vaccination and Cervical Cancer Screening Social Media Toolkit: Kenya
Increasing Uptake of HPV Vaccine in Kenya: An Action Guide for Civil Society Organisations
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