News Release

Cervical cancer deaths could be more than halved by WHO screening guidelines

Peer-Reviewed Publication

University of Sydney

HPV causing cervical cancer


Human Papilloma Virus (HPV) causes almost all cervical cancers, says Dr Kate Simms of the Daffodil Centre, and that a shift from Pap tests to HPV screening in low-and-middle-income countries, as has occurred in Australia, could significantly reduce mortality rates through earlier intervention.

view more 

Credit:, CC BY-SA 4.0 <>, via Wikimedia Commons

New research led by the Daffodil Centre* shows cervical cancer death rates in low-to-middle-income countries could be reduced by more than 63 percent through implementation of updated World Health Organization (WHO) screening guidelines.

The findings are published in two landmark papers in Nature Medicine driven by the Australian team from the Daffodil Centre, a joint venture of Cancer Council NSW and the University of Sydney, who were instrumental in driving changes to screening practices in Australia.

The two studies focus on screening for human papillomavirus (HPV) in the general population in 78 countries, and multiple screening scenarios for women with human immunodeficiency virus (HIV), calibrated for Tanzania, where HIV infection is endemic.

The studies model general population and targeted screening options in low-and-middle-income countries, and were conducted to support a major revision of WHO guidelines to inform the acceleration of WHO’s global strategy to eliminate cervical cancer.

Their publication follows the recent announcement of a $12.5 million Australian Government grant to a consortium led by the Daffodil Centre to support the elimination of cervical cancer in the Indo-Pacific region and related developments in Vanuatu and Papua New Guinea supported by philanthropic trust the Minderoo Foundation.

Lead author of the first study, Dr Kate Simms, said HPV caused almost all cervical cancers and that a shift from Pap tests to HPV screening in low-and-middle-income countries, as has occurred in Australia, could significantly reduce mortality rates through earlier intervention.

“Low-and-middle-income countries bear most of the world’s cervical cancer burden, so demonstrating the effectiveness of HPV-based screening compared with other approaches is crucial to advocacy to support the WHO strategy and guidelines,” Dr Simms said.

“We found that primary HPV screening was the most clinically effective and cost-effective, reducing mortality by 63-67 percent when offered every five years.”

Lead author of the second study, Dr Michaelia Hall, said women with HIV had a sixfold risk of developing cervical cancer compared with the general population and that co-existing HIV and HPV infection were more prevalent in low-to-middle-income countries.

“We modelled several scenarios in relation to outcomes in Tanzania, which has one of the world’s highest HIV infection rates, and found that primary HPV testing with triage compared with no screening would reduce cervical cancer mortality by up to 71 percent,” Dr Hall said.

“This equated to saving a life for every 38 women screened and referred for pre-cancer treatment – an extremely strong result in relation to the benefits of cancer screening.”

Both studies were based on a screening participation rate of 70 percent, a target which is one of the three pillars of the WHO global cervical cancer elimination strategy.

Daffodil Centre Director Professor Karen Canfell, who led modelling analysis that informed the WHO strategy and is senior author on both studies, said the findings should add to the momentum driving the elimination of cervical cancer in low-to-middle-income countries.

“In Australia, we’re on track to be the first country in the world to eliminate cervical cancer, by 2035, but in many countries it is a leading cause of cancer death – and causes huge inequities and impacts on entire communities,” Professor Canfell said.

“Yet it is the only cancer that can be eliminated, using technology that’s already well-established and available, if there is sufficient funding and community support.”

Professor Canfell said the $8.64 million Eliminating Cervical Cancer in the Western Pacific (ECCWP) project, funded by the Minderoo Foundation, was showing what could be achieved in low-to-middle-income countries by supporting the WHO triple strategy.

“By leveraging in-country partners and Australian technical expertise, ECCWP has set Vanuatu on a path to be the first low-to-middle-income country in the world to eliminate cervical cancer – while PNG is also taking important steps towards the elimination goal.

“The Australian Government’s $12.5 million dollar grant to fund the parallel EPICC [Elimination Partnership in the Indo-Pacific for Cervical Cancer] will further expand this approach, informed by the evidence.

“These two major new studies, notably in the prestigious Nature Medicine journal, strengthen the evidence base for action to guide and expand this work and accelerate the elimination of cervical cancer worldwide.”

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.