Cervical Cancer elimination strategy: action plan

Foreword by the Minister for Public Health and Women’s Health

Cancer remains a uniquely powerful disease – the diagnosis we all fear, and the cure for which we all hope. A complete cure for cancer remains elusive, but in cervical cancer, we have a disease that is almost entirely preventable. Not so long ago, preventing a cancer would have been considered science fiction, yet here and now, it is a reality.

Since 1988, cervical screening has been able to detect cell changes early enough for treatment to prevent cancer from developing. Two decades later, Scotland launched its HPV vaccination programme, and since then, no cases of HPV-related cervical cancer that are protected against have been detected in fully vaccinated women. That achievement is extraordinary. But almost 100 women still die every year in Scotland from cervical cancer. Hundreds more are diagnosed and may require extensive treatment.

By 2040, it is my confident hope that we will have changed that. Cervical cancer will be a rare disease – and a death from it will be even rarer.

To make that a reality, we must eliminate it. In Scotland, the rate of cervical cancer currently sits at 8.49 per 100,000^[1]. Elimination means fewer than four cases per 100,000 women^[2]. The World Health Organization^[3] (WHO) has shown us this is possible when we achieve the 90-70-90^[4] targets: 90% of girls fully vaccinated with HPV vaccine by age 15; 70% of women screened with a high‑performance test by ages 35 and 45; and 90% of women who require treatment receiving it. Scottish-specific modelling shows it is achievable by 2040, though it will take hard, ambitious work.

Both vaccine uptake and screening participation are declining. HPV vaccine coverage, once above 90%, has fallen in recent years; in 2024/25, coverage for girls leaving S4 was 85.7%^[5].

Screening uptake shows an even more pronounced decline. In 24/25, only 41.9% of women took up screening^[6]. We know the change to screening frequency has impacted how this statistic is calculated and it is probably an underestimate, but even the most optimistic interpretation shows we are far short of where we need to be.

These declines are seen across the UK and internationally, but they are not inevitable, and they must be reversed. More than that, we must reverse them equitably.

We know that inequalities affect people’s health outcomes, and that is particularly evident in the impact of cervical cancer. Women in the most deprived areas are four^[7] times more likely to die from cervical cancer than those in the least deprived. This is unjust. It must not continue.

That is why I established the Expert Group on Cervical Cancer Elimination^[8] and appointed Professor Anna Glasier, the Scottish Government’s Women’s Health Champion^[9] and a passionate advocate for equity, as its Chair. The Group has worked tirelessly to set out what must be done, lead by clinical expertise and real‑world experience. I am grateful for their leadership, energy and optimism, and for the recommendations^[10] that now underpin this action plan.

Those recommendations make clear that there are no quick fixes. Elimination requires time, investment, collaboration. But that, too, is why we should be hopeful.

We do not need a miracle. We simply need to do what works and do it well. We must be bold. We must modernise our systems. We must empower third‑sector organisations, schools, parents, local authorities and women themselves to play a part. All of this is within our grasp.

This action plan describes how we will set our course towards elimination. Other plans will follow, and we will need to take stock regularly, adjusting course if our progress stalls. Today, however, I am proud to set out this first plan — and hopeful that far from being daunted by the scale of the challenge, we will be motivated by the extraordinary potential it brings: to save lives; to prove the power of prevention; and to demonstrate that at least one cancer can, indeed, be beaten.

Jenni Minto, MSP, Minister for Public Health and Women’s Health