On November 17, 2025, the world observed the first World Cervical Cancer Elimination Day. The World Health Organization (WHO) endorsed this day in May 2025, five years after the World Health Assembly adopted resolutions urging countries to work toward eliminating cervical cancer as a public health problem. The strategy also aligns with the Sustainable Development Goals on reducing poverty, promoting health, gender equality and reducing inequality (Goals 1, 3, 5, and 10), making cervical cancer elimination a broad social commitment rather than only a health sector goal.
The strategy is built on the simple idea that no woman should die of a disease that is both preventable and curable when detected early. The WHO’s elimination agenda is anchored in concrete, measurable milestones of 90% HPV vaccination coverage (in school-going girls), 70% screening coverage (among women aged 35-45), and 90% treatment coverage (for confirmed cases). The target for elimination of cervical cancer as a public health problem is to reduce cervical cancer incidence to < 4 cases per 100,000 women-years. These resolutions shaped the global elimination strategy and set clear targets to be achieved by 2030.
Global burden
Cervical cancer remains one of the strongest indicators of health inequity. Close to 90% of global cervical cancer deaths occur in low and middle-income countries (LMICs), where access to vaccination, screening, and treatment is limited. Women in these regions are often diagnosed at advanced stages after years of unrecognised symptoms. The annual global burden, already at 570,000 new cases in 2018, is projected to rise to 700,000 by 2030, with deaths increasing from 311,000 to 400,000. The disease strikes during the most economically active years of life, affecting households, caregiving, and community participation.
Also Read: Keep it wholesome: On shaping a national cervical cancer control programme
The epidemiology
Cervical cancer is caused by persistent infection with the Human Papilloma Virus (HPV), a small double-stranded DNA virus that enters the cervical epithelium. The virus is transmitted mainly through sexual contact. Most infections clear on their own, but a small proportion persist and lead to precancerous changes that progress slowly over many years. High-risk HPV types (16 and 18) are responsible for the majority of cervical cancer cases. The risk of acquiring and retaining infection is shaped by early marriage and early sexual debut, which expose the cervix when it is still physiologically immature. Multiple sexual partners, high parity, poor genital hygiene, and limited access to healthcare increase the likelihood of long-term infection. Smoking reduces immune responses, while HIV infection significantly raises the risk of progression. Social factors, including lower education and reduced awareness of symptoms, further delay care seeking. These patterns explain why the disease remains concentrated in regions with limited resources.
Prevention framework
The WHO’s global elimination strategy is built on primary prevention (90% vaccine coverage), secondary prevention (70% of the target women population screened by HPV DNA testing) and tertiary prevention (90% treatment coverage). Primary prevention focuses on HPV vaccination for adolescent girls, ideally before sexual debut (9-14 years). It also includes comprehensive sexuality education, discouraging tobacco use, and promoting safe sexual practices. Secondary prevention relies on screening women at least twice in their lifetime, at the ages of 35 and 45 years, using high-performance tests such as HPV DNA testing. Women who screen positive require immediate or early treatment of precancerous lesions. Tertiary prevention includes timely management of invasive cancer through surgery, radiotherapy, chemotherapy, and palliative care.
India’s progress
India is shaping its approach across all three levels of prevention. In primary prevention, the country has announced its intention to introduce HPV vaccination for adolescent girls in a phased manner, through both school-based and community-based delivery, in the coming years. This rollout will be supported by targeted communication efforts to enhance acceptance and mitigate the spread of misinformation. Secondary prevention is carried out through the National Programme for Non-communicable Diseases, which recommends screening all women aged 30 years and above at primary health centres and sub-centres using the VIA-VILI technique. Strengthening follow-up of women who screen positive remains a priority. Tertiary care capacity is expanding through improved oncology services, the addition of radiotherapy units, and strengthened referral pathways. Many tertiary hospitals now manage early-stage disease with surgery or radiotherapy, but access continues to depend on geography and financial ability.
Surveillance systems
Reliable data systems are essential to verify and sustain elimination. Countries require population-based cancer registries to track incidence trends and medical certification of the cause of death to assess the mortality of cervical cancer cases accurately. Monitoring vaccination coverage, screening uptake, treatment completion, and survival outcomes helps determine whether countries are approaching the elimination threshold of < 4 /1,00,000 women years. Strengthening civil registration in vital statistics systems is therefore a core component of the strategy. In India, the Indian Council of Medical Research (ICMR) maintains cancer registries that include cervical cancer cases, and the Office of the Registrar General of India, under the Union Home Ministry, maintains the medical certification of cause of death.
Collaborative action
For every $1 invested in cervical cancer elimination, an estimated $3.20 will return by 2050 through increased participation of women in the workforce, and the benefits will rise to $26 when broader social gains are factored in. Achieving these targets could keep about 250,000 women productive, contributing nearly $28 billion to the global economy with an investment of just $10.5 billion by 2030.
The WHO emphasises the importance of political will, multisectoral coordination among government departments, the private sector, civil society, schools, and community organisations for successful elimination. School immunisation programmes, community health workers, local women’s groups, and survivor advocates improve awareness and acceptance of vaccination and screening. Partnerships help address myths, improve communication, and support vulnerable populations.
The first World Cervical Cancer Elimination Day, in 2025, marks the transition from aspiration to action. Countries now have clear targets and established tools in place. If the goals for vaccination, screening, and treatment are achieved by the year 2030, cervical cancer would become the first cancer that humanity can collectively eliminate through coordinated global public health action.
(Dr. C. Aravinda is an academic and public health physician. The views expressed are personal. aravindaaiimsjr10@hotmail.com)
Published – November 18, 2025 10:31 am IST
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