“Knowing is not enough; we must apply. Willing is not enough; we must do.” Goethe
Global Coalition Against Cervical Cancer™ Executive Summary:
Despite advances in prevention and control, cervical cancer remains the 2nd most common female tumor and cause of female cancer-related mortality globally. More than 85% of approximately 530,000 cervical cancer cases and 275,000 related deaths that occur in 2008 (http://globocan.iarc.fr/) occurred in low- and middle-income countries (LMIC), where cervical cancer is often the leading killer of women. Cervical cancer primarily afflicts populations because of a lack of access to basic healthcare services. And, unlike other major cancers, cervical cancer primarily occurs in women in their 30’s, 40’s, and 50’s, at an age when they are working and raising families, compounding the devastating social impact of this disease on families and communities.
An integrated model of cervical cancer prevention, control, and care will reduce the burden and death due to this disease now and risk of it in the future. Globally, there are 0.3 billion girls who need to be vaccinated against HPV, 0.75 billion women who need screening, management, and treatment for early detection of cervical precancer and curable cancers, and more than 500,000 women diagnosed with cervical cancer annually (and increasing every year) who are fighting for their survival or a better quality of their remaining life. Another 0.3 billion women will need vaccination and 0.3 billion women will need screening in the next 5 years. Although HPV vaccination may be the ultimate strategy for reducing the global burden of cervical cancer, it will be at least 20 years before the HPV vaccination reduces the burden of cervical cancer, even if HPV vaccination could be delivered throughout the world immediately. However, universal HPV vaccination is unlikely any time soon; the Global Alliance for Vaccination and Immunization has set a target of vaccinating 30 million girls by 2020, less than 10% of those who would benefit. Thus, screening and treatment of precancer and early cancer and palliative care for late-stage cancer will be needed for the foreseeable future. As advances in cervical cancer prevention and control are now more affordable, we must act to avert millions of women from dying unnecessarily from this highly preventable disease.
In addition, there will be important benefits beyond reducing the burden of cervical cancer. Expanding and improving systems of vaccine delivery will increase coverage for HPV vaccines and other life-saving vaccines. Establishing screening, management and diagnosis, treatment, and palliative care programs will increase capacity for delivery of healthcare (e.g., laboratory medicine, pathology, and patient tracking) for other cancers and non-communicable diseases.
Global Coalition against Cervical Cancer (GC3)™ is a large, international cooperative effort that will serve as an independent, credible source for technical support and expertise, technology transfer, training, and education to assist countries and entities that want to implement scaled-up cervical cancer prevention and control programs. We will address the unmet need to provide the critical know-how to implement life-saving cervical cancer prevention programs, with a particular emphasis on secondary prevention through screening, early detection, and timely treatment. For example, GC3 will play a key role in needs assessment/gap analysis, program design and demonstration projections, and monitoring and evaluation. We will be a source for education and evidence-based information. We will be honest brokers and help countries and programs make informed decisions based on evidence about which cervical cancer prevention and control programs best serve their needs. We will commit to supporting the building of healthcare infrastructure for these programs that will eventually also serve other healthcare needs that burden these same populations.