Cervical Cancer Screening in Transition: Global Challenges and Local Realities - Review article

Sep 23, 2026

Uploaded by Bulrr

Cervical cancer is a major global public health problem that disproportionately affects women in low- and middle-income countries (LMICs), despite strong prevention potential through effective primary and secondary prophylaxis. Persistent high-risk human papillomavirus (HPV) infection is the principal cause, underscoring the combined value of HPV vaccination and HPV-based screening. This narrative review synthesizes evidence on cervical cancer natural history, prevention, and epidemiology, emphasizing screening practices, emerging methods, global incidence and mortality patterns, regional contexts, and the evolution of cytology, HPV DNA testing, and self-sampling approaches, aligned with the WHO elimination strategy.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages26

Reading Time1 h 6 min

AccessFree to download

Abstract

Introduction

Disease burden and preventability

Prevention methods: vaccination and screening

Inequality in access to preventive services

WHO global elimination strategy

Review focus and scope

International Journal of Women’s Health Open Access Full Text Article REVIEW Cervical Cancer Screening in Transition: Global Challenges and Local Realities Altynshash Rakhat 1 , Gulzhanat Aimagambetova 2 , 3 1School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan; 2Department of Surgery, School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan; 3Clinical Academic Department of Women’s Health, CF “University Medical Center”, Astana, 10000, Kazakhstan Correspondence: Gulzhanat Aimagambetova, Department of Surgery, Nazarbayev University School of Medicine, Kabanbay Batyr 53, Astana, 010000, Kazakhstan, [Email gulzhanat.aimagambetova@nu.edu.kz](Email gulzhanat.aimagambetova@nu.edu.kz) | Abstract: Cervical cancer remains a major global public health concern that disproportionally affects women in low- and middleincome countries (LMICs), despite being largely preventable through effective primary and secondary prophylaxis. Persistent infection with high-risk human papillomavirus (HPV) is the principal cause of cervical cancer, highlighting the importance of both HPV vaccination and HPV-based screening. This narrative review examines current evidence on the natural history, prevention, and epidemiology of cervical cancer, with particular emphasis on screening practices and emerging innovative methods. It highlights the global patterns in cervical cancer incidence and mortality and provides regional contexts with the specific focus on the evolution of cervical cancer screening techniques, including cytology-based methods, HPV DNA testing, and the increasing role of self-sampling approach. Future perspectives are discussed in relation to the World Health Organization’s cervical cancer elimination strategy. Keywords: cervical cancer, HPV, HPV vaccination, cervical cancer screening, Pap test, HPV genotyping, self-sampling, prevention, healthcare access | | --- | | Introduction
Cervical cancer remains a major public health burden and stands as one of the most common cancers affecting women worldwide and disproportionately impacts low- and middle-income countries (LMICs) .1,2 Cervical cancer is widely recognized as one of the most preventable diseases since it has a well-proven and essential causal agent, persistent infection with high-risk human papillomavirus (HPV) .1,3,4 The connection between cervical cancer and carcinogenic HPV types establishes that existing prevention methods succeed in discontinuing the disease progression before patients develop invasive cancer.5–7 The natural history of this disease provides two prevention methods: HPV vaccination reduces the risk of oncogenic type infection, while screening, together with early treatment, enables healthcare professionals to find and treat precancerous conditions.8,9 The worldwide distribution of preventive healthcare services remains highly unequal; therefore, women in LMICs continue to experience greater disease burden.3,6
The existing health gaps show that people lack access to essential preventive services, which include HPV vaccination, organized cervical cancer screening procedures, and immediate diagnosis and treatment. Screening effectiveness depends on test performance and delivery systems, and follow-up pathways and population participation; therefore, officials need to conduct discussions about which screening methods to use and how to implement those methods for elimination efforts.10–13The implementation of screening methods through organized population-based programs has demonstrated strong evidence that screening methods like cytology and visual inspection with acetic acid and hrHPV testing can reduce both cervical cancer rates and cancer-related deaths.9, 14–16
To prevent cervical cancer and decrease the incidence of the disease, the World Health Organization (WHO) developed the Global Strategy to Accelerate the Elimination of Cervical Cancer.6 The strategy aims for (1) 90% of girls to be fully vaccinated against H

FAQs

Why is HPV infection central to cervical cancer prevention?

Persistent infection with high-risk HPV types is the principal cause of cervical cancer. This link enables prevention by preventing oncogenic infection through vaccination and detecting precancer through screening and early treatment.

Which cervical cancer screening approaches are highlighted in the review?

The review emphasizes cytology-based methods, HPV DNA testing, and emerging innovations including self-sampling. It also discusses organized program approaches using cytology, visual inspection with acetic acid, and hrHPV testing.

What are the WHO goals for cervical cancer elimination mentioned in the document?

The WHO strategy targets: 90% HPV vaccination of girls by age 15, 70% of women receiving high-performance test screening at least twice during their lifetime (by ages 35 and 45), and 90% of women with cervical disease receiving suitable care and treatment.

Sep 23, 2026

Uploaded by Bulrr