A new modelling study published in The Lancet has raised concerns that global inequalities in cervical cancer burden could widen substantially over the coming decades unless low- and middle-income countries (LMICs) rapidly expand access to Human papillomavirus (HPV) vaccination, cervical cancer screening, and treatment programs.
Cervical cancer, which is primarily caused by persistent infection with HPV, remains the fourth most common cancer among women worldwide. More than 600,000 new cases and over 340,000 deaths are reported each year, with the vast majority occurring in LMICs. Despite being one of the most preventable cancers, major disparities persist between high-income countries (HICs) and resource-limited regions.
According to the study, women living in LMICs currently face cervical cancer incidence rates that are nearly three times higher and mortality rates up to six times greater than those in HICs. Researchers attribute this imbalance largely to inadequate access to preventive healthcare services, including vaccination and early detection programs.
The analysis highlights differences in screening uptake worldwide. While approximately 84% of women in HICs have undergone cervical cancer screening at least once, only around 10% of women in LMICs have access to similar services. Screening programs, including Pap smears and HPV testing, play a critical role in detecting precancerous lesions before they progress to invasive cancer. However, weak healthcare infrastructure, workforce shortages, and limited awareness continue to hinder implementation in many low-resource settings.
The study also points to substantial inequities in HPV vaccination coverage. In 2023, only 23% of eligible girls in LMICs received HPV vaccination compared with 57% in HICs. Although recent reductions in vaccine prices and improved global supply have increased accessibility, several challenges remain, including funding limitations, vaccine hesitancy, logistical barriers, and disruptions caused by the COVID-19 pandemic.
Researchers warn that if current prevention strategies continue unchanged, the global gap in cervical cancer burden may worsen considerably. The model predicts that inequality in cervical cancer incidence between HICs and LMICs could increase from approximately threefold in 2022 to as much as twelvefold by 2105. Under existing trends, many HICs are expected to achieve cervical cancer elimination by around 2048, while LMICs would experience only modest declines in disease burden.
The findings underscore the urgent need for large-scale investment in prevention initiatives. Expanding HPV vaccination coverage among girls in LMICs to 90% could dramatically reduce future disease burden and narrow global disparities. Nevertheless, the researchers emphasize that vaccination alone is insufficient, as its impact on population-level cancer incidence would take decades to become fully apparent and would not address women already infected with HPV.
The study therefore advocates for a comprehensive prevention strategy combining vaccination with routine screening and timely treatment of precancerous lesions. This approach aligns with the World Health Organization global strategy launched in 2020, which aims to achieve 90% HPV vaccination coverage, 70% screening coverage, and 90% treatment access for cervical precancer and cancer.
According to the modelling estimates, achieving these targets could prevent nearly six million additional cervical cancer cases in LMICs and substantially accelerate progress toward elimination worldwide. Furthermore, the combined implementation of widespread vaccination, effective screening, and treatment programs could potentially eliminate cervical cancer as a public health problem globally by 2070 and avert up to 37 million cases over the next century.
Researchers conclude that without urgent international action, preventable disparities in cervical cancer outcomes are likely to continue widening. They stress that equitable access to vaccination, screening, and treatment services will be essential to achieving a cervical cancer–free future and reducing the disproportionate burden borne by women in low-resource countries.
References
- Brisson M, Drolet M, Gingras G, Laprise JF, Chamberland É, Bruni L, et al. Substantial increases in cervical cancer inequalities worldwide without enhanced human papillomavirus vaccination and screening efforts: a global modelling study. The Lancet. 2026; doi:10.1016/S0140-6736(26)00410-1.