Cervical Cancer Elimination in Scotland Expert Group Final Report
A report prepared by an Expert Group on Cervical Cancer Elimination in Scotland
4. Overview of the World Health Organisation (WHO) targets and indicators
The WHO Cervical Cancer Elimination Strategy[7], launched in 2020, aims to eliminate cervical cancer as a public health problem within the next century - meaning fewer than 4 cases per 100,000 women. Scotland's age standardised incidence rate in 2022 was 9.0 per 100,000, with the burden of disease being larger in the most deprived groups.
The strategy is built around a three-pillar approach including primary prevention, with a focus on Human Papillomavirus (HPV) vaccination, secondary prevention with a focus on cervical screening and pre-cancer treatment, and tertiary prevention with a focus on treatment for those with cervical cancer. To reach its vision, the WHO set the 90-70-90 targets that must be met by 2030 and maintained for countries to be on the path towards cervical cancer elimination:
- vaccination: 90% of girls fully vaccinated with the HPV vaccine by the age of 15
- screening: 70% of women screened using a high-performance test by the age of 35, and again by the age of 45
- treatment: 90% of women with pre-cancer treated and 90% of women with invasive cancer managed
The evaluation of the impact of interventions and activities implemented as part of a national cervical cancer elimination strategy needs both a framework and tools to determine the baseline position; monitor progress; and identify gaps and interventions to improve coverage, quality and outcomes.
To support the implementation of the global strategy to eliminate cervical cancer as a public health problem, the WHO published a framework detailing targets, indicators, and strategies for prevention, screening and treatment[8].