Each year, cervical cancer affects over half a million people around the world, with one person dying of the disease every two minutes. It is one of the greatest threats to women's health we know of. It is also entirely within our power to wipe out.
Researchers in Australia are now dangling that carrot in front of the world. Their newest findings suggest that the World Health Organisation's urgent call for global elimination of cervical cancer is well within our grasp.
Starting next year, the authors say, if we can achieve widespread vaccination coverage and expand cervical screenings, we could see this cancer eliminated in 149 out of all 181 countries by the turn of the century.
Using dynamic models and high quality data from the International Agency for Research on Cancer, the authors predict that taking these steps will prevent up to 13.4 million cases of cervical cancer within 50 years (2069).
"More than two thirds of cases prevented would be in countries with low and medium levels of human development like India, Nigeria, and Malawi, where there has so far been limited access to HPV vaccination or cervical screening," says lead author Karen Canfell, a cancer epidemiologist from the Cancer Council in Sydney, Australia.
The carrot is juicy, but the stick might get us moving faster. Because of population growth and ageing, the number of cervical cancer cases is set to rise worldwide from 600,000 per year in 2020 to 1.3 million per year in 2069.
Nor does the burden of cervical cancer fall equally. Today, around 85 percent of cervical cancer cases occur in less developed regions, in part because screening rates and vaccination rates are significantly lower.
The new research reveals that if we fail to expand these prevention programs, more than 44 million women globally will be diagnosed with cervical cancer in the next 50 years. Of that number, around two thirds will likely be fatal, leading to 15 million deaths.
"Our challenge is to ensure that all girls globally are vaccinated against HPV and that every woman over 30 is screened and treated for pre-cancerous lesions," announced the Director General of WHO last year.
Australia is well on its way to showing the rest of the world how to do just that. Its current national prevention program is working exceptionally well - so well, in fact, that the authors think the nation's rate of cases might fall below the elimination threshold (4 in 100,000) within just nine years.
Other high-income countries, such as the US, Finland, the UK, and Canada, could achieve the same results within 25-40 years. Whereas, countries considered less developed - such as Ethiopia, Haiti and Papua New Guinea - might take a few decades longer.
Still, one region of the world is so far behind, it needs more time to catch up. Even if prevention programs are rapidly expanded, the authors predict no individual country in Africa will be able to eliminate cervical cancer by 2100.
It just goes to show how much work there remains to be done, and how much we stand to lose if we do not act soon - but also, that the tools to save millions of lives are in our hands.
"The WHO call-to-action provides an enormous opportunity to increase the level of investment in proven cervical cancer interventions in the world's poorest countries," says Canfell.
"Failure to adopt these interventions will lead to millions of avoidable premature deaths."
This study has been published in The Lancet Oncology.