Screening – A Vital Weapon in the Fight Against Cervical Cancer
Cervical cancer is the fourth most common cancer in women. In 2020, 194 countries committed to the World Health Organization’s goal to eliminate it. The 90-70-90 global strategy deadline is 2030, but can it be achieved?
Globally, cervical cancer remains a significant threat, with approximately 660,000 new cases and 350,000 deaths reported in 2022.1 Nearly 90% of deaths occur in women aged 40 years and older with the greatest burden occurring in low and middle income countries.2 China and India together account for 42% of cases and 39% of deaths.3 If diagnosed at an early stage and treated promptly, cervical cancer can be cured.
Eliminating Cervical Cancer
The discovery in the 1980s of the link between persistent chronic human papillomavirus (HPV) infection and cervical cancer led to the development of HPV focused vaccines and screening tests. Consequently, screening and vaccination are central pillars in the World Health Organization’s (WHO) Global Initiative for Accelerated Elimination of Cervical Cancer. This initiative set national 90–70–90 targets for 2030:
- 90% of girls receive an HPV vaccine by age 15
- 70% of women at age 35 and 45 screened with high-performance tests
- 90% of women with precancerous lesions or invasive cancer treated.3
Screening for cancer
Screening is designed to detect the presence of an HPV infection and/or to identify precancerous cell changes, enabling early intervention. Finding cancer early usually leads to better outcomes as illustrated by evidence showing that organised screening reduces deaths from cervical cancer with mortality reduction rates in Europe ranging from 41% to 92%.4
Screening programmes vary globally. Some countries opt for nationally or regionally organised programmes for women meeting eligibility criteria, while others employ opportunistic screening. However, even in countries with a well-organised screening system, such as in Europe, Australia, Canada and the US, attendance shortfalls remain.5 For example, in the Netherlands participation declined from between 64.4%-66.2% in a three-year period (2012 to 2015) to 57.4% in 2017.6 This is a major concern, as flat or declining screening rates represent lost opportunities for early detection and diagnosis of cancer.
The tests used within the programmes also differ. Some countries, like Sweden, the Netherlands and the UK, use HPV-based screening instead of cytology-based screening, while others use cytological methods.7 In many countries, the approach depends on the age of the woman being tested. For example, in France, women 25 to 29 are offered a cytology exam but women aged 30-65 are offered an HPV test.8
Barriers to screening
Multiple factors act as barriers to women participating in screening and contribute to declining participation. These include:
- financial obstacles – cost and lack of insurance particularly in countries without universal healthcare
- lack of knowledge and awareness about cervical cancer and screening
- societal prejudices – cultural and/or religious
- access issue linked to distance to healthcare facilities and transport
- fear and embarrassment
- and lack of trust in healthcare systems.9
A recent McKinsey report on women’s health, emphasised that education on the importance of screening is fundamental to boosting attendance.10 Therefore, ensuring access to accurate, comprehensive information and ongoing education about screening must be a cornerstone of all strategies driving attendance.
What next?
Improving attendance through education, clear communication and engagement, alongside expanding access, establishing best practices and adopting high-performance screening tests, will be vital in reaching WHO’s 2030 goals. As global efforts continue, screening remains a vital weapon in the fight against cervical cancer, offering hope for eventual elimination of this preventable disease.
For more information, visit the Cervical Health Solution page.
For more insight articles, visit the Hologic Innovation Exchange.
- World Health Organization. Cervical Cancer. 5 March 2024. www.who.int/news-room/fact-sheets/detail/cervical-cancer
- World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. 2020 www.who.int/publications/i/item/9789240014107. . https://iris.who.int/server/api/core/bitstreams/4e245e89-ddcc-488f-97c7-9de5e08524ef/content
- Wu J, Jin Q, Zhang Y, et al. Global burden of cervical cancer: current estimates, temporal trend and future projections based on the GLOBOCAN 2022. Journal of the National Cancer Center, 2025;5 (3):322-329
- Jansen EEL, Zielonke N, Gini A, et al. EU-TOPIA consortium. Effect of organised cervical cancer screening on cervical cancer mortality in Europe: a systematic review. Eur J Cancer, 2020;127:207-223
- Zielonke N, Kregting LM, Heijnsdijk EAM, et al. The potential of breast cancer screening in Europe. Int. J. Cancer. 2021;148: 406–418
- Aitken CA, Kaljouw S, Siebers AG, et al. Investigating the decrease in participation in the Dutch cervical cancer screening programme: The role of personal and organisational characteristics. Prev Med Rep. 2021 Feb 20;22:101328
- Maver PJ, Poljak M. Primary HPV-based cervical cancer screening in Europe: implementation status, challenges, and future plans. Clinical Microbiology and Infection, 2020;26:579-583
- L’Assurance Maladie. [Internet] Organized screening for cervical cancer. [Cited December 2025] https://www.ameli.fr/laboratoire-danalyses-medicales/exercice-liberal/prise-charge-patients/depistage-organise-du-cancer-du-col-de-l-uterus?lang=en
- Farajimakin O. Barriers to Cervical Cancer Screening: A Systematic Review. Cureus, 2024 Jul 28;16(7):e65555
- McKinsey Health Institute. Closing the women’s health gap: A $1 trillion opportunity to improve lives and economies. [Cited December 2025] https://www.mckinsey.com/mhi/our-insights/closing-the-womens-health-gap-a-1-trillion-dollar-opportunity-to-improve-lives-and-economies