• Uterine Cervical Neoplasms

Cervical cancer is a significant global health issue, especially in low- and middle-income countries where disparities in epidemiology, clinicopathology, management, immunity, and drug access are stark.1 In 2022, it was the fourth most common and lethal cancer worldwide. Africa experiences some of the highest incidence and mortality rates, with a 10-fold increase compared with other regions.2 Sub-Saharan Africa bears the heaviest burden, with 18 of the 20 countries with the highest cervical cancer incidence,3 accounting for 90% of global cervical cancer deaths in 2020.4 Despite being largely preventable, limited access to vaccination, screening, and timely treatment continues to impact millions of women. This contrast underscores the urgent need for targeted prevention and treatment strategies in high-burden regions.

In response, the Prevention Committee at the European Society of Gynaecological Oncology (ESGO) focuses on turning scientific knowledge into tailored region-specific strategies. Over the last 6 years, it has led many initiatives bridging knowledge and practice. The recent African ESGO Virtual Conference gathered more than 1200 participants to advance Human papillomavirus (HPV) vaccination, screening, and treatment strategies while fostering global collaboration. Participants included government representatives and key societies – the Middle East and Mediterranean Association of Gynecologic Oncologist (MEMAGO), the Pan-Arabian Research Society of Gynecologic Oncology (PARSGO), and the Breast and Gynecological International Cancer Society (BGICS).

The full-day webinar highlighted the need for region-specific cervical cancer prevention and management strategies, focusing on expanding HPV vaccination, screening methods, and addressing healthcare access barriers in underserved areas. Presentations on local experiences showcased practical approaches and challenges. A webinar survey showed that 74% of the respondents believe that onsite visits from ESGO-experts would significantly enhance training for local healthcare providers.

The presentations and the discussions highlighted critical gaps, stressing the need for stronger political support, better education, greater awareness, and faster diagnostics through timely screening, risk-based treatment, and improved pathology services; particularly in developing countries where inadequate awareness and absent screening programs often lead to delayed diagnoses at more advanced stages and poorer prognosis.5

Among discussed projects, CarciSCAN in Ghana focuses on implementing high-risk HPV self-sampling, with 600 participants already enrolled in the program. Despite cost challenges, the study aims to develop sustainable outreach and introduce HPV vaccination.6 Another initiative, the Elikia Project in Kinshasa, trains local professionals in visual inspection with acetic acid (VIA) and thermal ablation while exploring innovative tools like smartphone cervicography and AI diagnostics. Recently, the project has expanded to include local HPV testing and self-sampling.7 8 These initiatives are vital for developing adaptable, cost-effective models that contribute to the global goal of cervical cancer elimination. Success relies on understanding regional contexts, tailoring interventions, and building sustainable partnerships. A webinar survey indicated a strong desire for international collaboration, with 74% confident in partnerships with international gynecological societies, though only 31% have seen significant policy changes since the WHO’s 2018 call for cervical cancer elimination.

ESGO remains committed to supporting cervical cancer elimination through initiatives that provide essential resources, expert knowledge, and collaboration opportunities, enhancing education, training, and patient engagement in Africa and other low- and middle-income countries. ESGO’s approach prioritizes practical, achievable strategies by leveraging existing tools, developing resource-adapted guidelines, and focusing on cost-effective solutions to reduce regional disparities in care.