Cervical cancer is the third most common cancer worldwide, and 80% of cases occur in the developing world. It is the leading cause of death from cancer among women in developing countries, where it causes about 190,000 deaths each year.1 Rates of the disease are highest in Central America, sub-Saharan Africa, and Melanesia (M Parkin, International Agency for Research on Cancer, personal communication, July 2000).
Unlike many cancers, cervical cancer can be prevented. Primary prevention of cervical cancer through preventing human papillomavirus (HPV) infection, a sexually transmitted agent that causes cervical cancer, will contribute to reducing cancer mortality. Primary prevention of HPV infection is more challenging than prevention of most other sexually transmitted infections. HPV-infected women generally are asymptomatic, HPV is transmitted easily, and no therapies eliminate the underlying infection. The development of a vaccine against HPV is under investigation, but vaccination as a
means of primary prevention is years away. Secondary prevention involves using relatively cheap screening and treatment technologies that can detect dysplasia before it progresses to invasive cancer.
