WHO Recommendations for screening and treatment to prevent cervical cancer

Too many women worldwide – particularly the poorest women – continue to die from cervical cancer; a disease that is both preventable and treatable. In order to help countries make faster progress, more equitably, on the screening and treatment of this devastating disease, WHO and HRP have launched a new guideline.

The new guideline includes some important shifts in WHO’s recommended approaches to cervical screening. In particular, it recommends an HPV DNA-based test as the preferred method, rather than a visual inspection with acetic acid (VIA) or cytology (commonly known as a ‘Pap smear’), currently the most commonly used method to detect pre-cancer lesions globally.

HPV-DNA testing detects high-risk strains of HPV which cause almost all cervical cancers. Unlike tests that rely on visual inspection, HPV-DNA testing is an objective diagnostic, leaving no space for interpretation of results.

Although the process for a healthcare provider obtaining a cervical sample is similar with both cytology or HPV DNA testing, HPV DNA testing is simpler, prevents more pre-cancers and cancer, and saves more lives than VIA or cytology. In addition, it is more cost-effective.

More access to commodities and self-sampling is another route to consider for reaching the global strategy target of 70% testing by 2030. 
 

Summary Recommendation for the General Population of Women

WHO suggests using either of the following strategies for cervical cancer prevention:

• HPV DNA detection in a screen-and-treat approach starting at the age of 30 years with regular screening every 5 to 10 years.
• HPV DNA detection in a screen, triage and treat approach starting at the age of 30 years with regular screening every 5 to 10 years.
   

Summary Recommendation for Women with HIV

WHO suggests using the following strategy for cervical cancer prevention:

• HPV DNA detection in a screen, triage and treat approach starting at the age of 25 with regular screening every 3 to 5 years.