India has highest number of women dying from cervical cancer. Australia provides a global model for dramatically preventing cervical cancer.
More women die of cervical cancer in India than anywhere in the world. India along with China, Brazil, Bangladesh and Nigeria represent over 50% of the global burden of cervical cancer deaths.
However, African countries are struggling to deal with cervical cancer too according to the new Cervical Cancer Crisis Card, which ranks countries from across the world based on the number of deaths from cervical cancer and the mortality rate from this preventable disease. The Crisis Card is available on the Cervical Cancer Free Coalition website and is being launched globally to mark International Mother’s Day on Sunday 12th May.
“Despite the great burden of this disease there are exciting opportunities for prevention with breakthroughs in available options for cervical screening in low resource settings” said Dr. Usha Rani Poli Associate Professor of Gynaec Oncology at the MNJ Institute of Oncology & Regional cancer Center in Hyderabad. “Still major barriers need to be addressed, community mobilization is critical to educate the public on the importance of screening and to break down cultural barriers about discussing sexual issues.”
According to the Crisis Card, Australia has the lowest cervical cancer mortality rate, which is due to the successful rollout of a comprehensive package of HPV vaccines, treatment and prevention. According to the Government of Australia, there has also been a decline in genital warts and cervical abnormalities among young women since the introduction of the HPV vaccine in Australia.
Dr Jennifer Smith, Executive Director of the Cervical Cancer Free Coalition said: “Cervical cancer is a preventable cancer, yet we are still seeing so many deaths around the world. At Cervical Cancer Free Coalition we are working towards building networks across the globe to help support our common goal of a world free of cervical cancer. Together we can dramatically reduce this disease through vaccination, screening and education.”
The startling disparities between women in the developed and developing world are personified by cervical cancer. A woman in Zambia is 25 time more likely to die from cervical cancer than a woman in Australia and India has 750 times more deaths than Norway. This level of inequity is also reflected across gender indicators with girls less likely to attend school but more likely to be malnourished and married as a child.
Coming in the same month as the global Women Deliver 2013 conference that will have a focus on gender and health equity in terms of the post-2015 framework (the follow-up framework to the Millennium Development Goals), the report is a timely reminder of the challenges facing women, especially in the low and middle-income countries. By prioritising women’s health in the next developmental framework, world leaders would show that they’re serious about challenging inequity and building sustainable societies where universal rights are guaranteed for all.
Yuvraj Singh, former India Vice Cricket Captain and cancer survivor who is attending Women Deliver 2013 said, “If there is something that I have learnt in my battle with cancer, it is, to use a clichéd term, Prevention is better than cure. This Mother’s Day, let’s pledge to keep our mothers safe. Let’s protect the women in our families. It’s time we showed that we care”
Cervical cancer is a taboo issue in many places as it is linked to sexual reproduction and cancer. Unless women’s groups and civil society join together to lead movements that break through stigma, patriarchy and other societal barriers, we will continue to see large numbers of deaths and high mortality rates. Projections show that by 2030, almost half a million women will die of cervical cancer, with over 98% of these deaths expected to occur in low and middle-income countries. The time to act is now.
The crisis card also calls for:
– The rollout of a comprehensive approach to cervical cancer that includes the aggressive rollout of HPV vaccines that prevent disease and for the scaling up of screening and treatment options.
– Women to be encouraged to visit their health provider for early screening of precancers using either the pap smear (colposcopy), visual inspection with acetic acid (VIA) and HPV testing to help diagnose precancerous cells.
– Treatment of precancers is advancing, which provides hope to the hundreds of thousands of women who missed out on the vaccine. Health systems need to be strengthened so that all women who need access to treatment can access affordable, quality care.
Utilising official data from reports by the World Health Organisation, United Nations, The World Bank and IARC Globocan, this list of 50 countries were chosen to provide a snapshot of the world and reflect geographic, economic and population variations (and where data was available — some countries like Afghanistan have insufficient data). Cervical cancer data can be found for all countries at the World Health Organisation website
Cervical Cancer Global Crisis Card
Cervical cancer kills an estimated 275,000 women every year and 500,000 new cases are reported worldwide. This entirely preventable disease is the second largest cancer killer of women in low and middle-income countries, with most women dying in the prime of life.
While numerous tools and technologies exist to prevent cervical cancer, these interventions remain largely inaccessible to the girls and women who need them most. Despite the proven link between the Human Papillomavirus (HPV) and cervical cancer, HPV vaccines are not yet widely available and screening rates remain low in much of the world. Lack of awareness and deep-seated stigma associated with the disease also pose significant barriers to access.
Projections show that by 2030, almost half a million women will die of cervical cancer, with over 98% of these deaths expected to occur in low and middle-income countries.
The hard facts
Using data from the WHO, United Nations, the World Bank and IARC Globocan, the cervical cancer crisis cards highlight the inequity women face depending on where they live. Fifty countries were selected to provide a snapshot of the world and reflect geographic, economic and population variations (and where data was available).
The Cervical Cancer Crisis Card: Death Count, reveals the huge number of women dying in Asia. India alone represents 26.4% of all women dying of cervical cancer globally, with China, Bangladesh, Pakistan, Indonesia and Thailand also showing high death incidence.
The Cervical Cancer Crisis Card:
Mortality Rates highlights that Africa is the most dangerous place to be a woman with cervical cancer. All ten of the countries with the highest cervical cancer mortality rate can be found in Africa. In a positive sign of what can be achieved, Australia has had a successful national rollout of the HPV vaccine and has seen a decline in genital warts and cervical abnormalities among young women since its introduction.
Overcoming the crisis
Cervical cancer is almost entirely preventable and if the world followed Australia’s example of rolling out comprehensive vaccination, screening and treatment, we would see mortality rates and the death rates dramatically reduce.
We have safe and efficacious HPV vaccines available on the market to prevent infection with the main cancer causing strands. For early screening of precancers the pap smear (colposcopy), visual inspection with acetic acid (VIA) and HPV testing can help diagnose early cancerous cells. Treatment of precancers is also advancing, which provides hope to the hundreds of thousands of women who missed out on the vaccine. This also emphasizes the need for women to be screened regularly.
Innovative funding mechanisms to increase access to HPV vaccines and screening tools are being developed. Several countries around the world, such as Malaysia, Mexico and Rwanda have shown leadership in strengthening cervical cancer prevention. With funders and country governments increasingly working together with vaccine manufacturers and donors to ensure access and affordability of HPV vaccines, we must ensure that we take action to cut both the death count and mortality rate of cervical cancer.
Global Form on Cervical Cancer Prevention
World leaders and experts are uniting in Kuala Lumpur later this month to plot out a roadmap to ensure that all women and girls have equitable access to HPV vaccines, screening and treatment.
Whatever the outcome, it will be critical that at the local, national and international levels we work in partnership to ensure that words are turned into action and we use the tools and technologies available to prevent cervical cancer.