CDC Activities for Improving Implementation of Human Papillomavirus Vaccination, Cervical Cancer Screening, and Surveillance Worldwide

Abstract

Cervical cancer incidence and mortality rates are high, particularly in developing countries. Most cervical cancers can be prevented by human papillomavirus (HPV) vaccination, screening, and timely treatment. The US Centers for Disease Control and Prevention (CDC) provides global technical assistance for implementation and evaluation of HPV vaccination pilot projects and programs and laboratory-related HPV activities to assess HPV vaccines. CDC collaborates with global partners to develop global cervical cancer screening recommendations and manuals, implement screening, create standardized evaluation tools, and provide expertise to monitor outcomes. CDC also trains epidemiologists in cancer prevention through its Field Epidemiology Training Program and is working to improve cancer surveillance by supporting efforts of the World Health Organization in developing cancer registry hubs and assisting countries in estimating costs for developing population-based cancer registries. These activities contribute to the Global Health Security Agenda action packages to improve immunization, surveillance, and the public health workforce globally.

Keywords: CDC; Centers for Disease Control and Prevention; HPV; cervical cancer; global health security; human papillomavirus; incidence rates; mortality rates; screening; sexually transmitted infections; surveillance; vaccination; viruses.

Figure

Worldwide cervical cancer incidence and human papillomavirus (HPV) vaccination status. A) Estimated cervical cancer incidence rates per 100,000 persons in 2012. Source: GLOBOCAN, 2012, WHO. B) Progress in HPV vaccine introduction in national immunization programs, 2016. Source: WHO, 2016. Many countries with high cervical cancer incidence rates (primarily countries in sub-Saharan Africa, Asia, and a few in Latin America) have not yet introduced HPV vaccination in their national immunization programs. Cervical cancer can also be prevented by screening and treatment for precancerous lesions; incidence and mortality rates in high-income countries have decreased largely because of effective screening programs. Data for cervical cancer screening coverage worldwide are limited; 2002 World Health Survey data showed that the proportion of women who had a Papanicolaou test in the previous 3 years greatly varied among countries; 11%–83% in industrialized countries, and 1%–73% in developing countries (5). WHO, World Health Organization.