Examining policy cohesion for cervical cancer worldwide: analysis of WHO country reports

doi:10.1136/esmoopen-2020-000878

ESMO Open

Volume 5, Issue 6, 2020, e000878

https://doi.org/10.1136/esmoopen-2020-000878 Get rights and content

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open access

ABSTRACT

Introduction

Cervical cancer is controllable through appropriate interventions such as vaccination, screening, treatment, early diagnosis and palliative care. The greatest burden of cervical cancer lies in low-income countries (LIC) where most of these services are missing or developed asymmetrically. Indeed, it is important to have not just an expansion, but a symmetric and concordant development of each service. Therefore, policies of countries should be aligned to provide concordant services and achieve the best outcomes with available resources. This is called ‘policy cohesion’ and for the first time in literature we will analyse cervical cancer policy coherence in all the 194 WHO member states.

Methods

The study is based on the 2017 WHO Non-Communicable Disease Country Capacity Surveys (NCD CCS). Although the survey covers multiple non-communicable diseases, in this report we will only discuss those results pertaining to cervical cancer, analysing the cervical cancer policy cohesion of 194 WHO member states, divided by WHO region and World Bank income group.

Results

Human papilloma virus vaccination exists in 53% of countries. 76% of countries offer cervical screening: among these countries, treatment, early diagnosis guidelines and palliative care are missing in 13%, 13% and 40%, respectively. In the African region, this discord is even more profound: 32%, 17% and 60%, respectively.

Conclusion

Especially in those settings where resources are limited, early detection guidelines, treatment and palliative care should be implemented along with secondary prevention strategies. Symmetric development of concordant cervical cancer services maximises cervical cancer control efficacy.

WHO

cervical cancer

policy cohesion

gynaecologic oncology

oncology

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Twitter: @darioT_

Contributors: LE and RH contributed to writing original draft, project administration, investigation and conceptualisation; AG to writing review and editing, project administration, conceptualisation and writing original draft; SCH to visualisation, resources and data curation; CGL to visualisation, methodology and data curation; EF and DT to visualisation, supervision, conceptualisation and data curation; RA to supervision and conceptualisation; XC to visualisation, validation, software and formal analysis; AI to visualisation, supervision and conceptualisation.

Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests: None declared.

Patient consent for publication: Not required.

Provenance and peer review: Not commissioned; externally peer reviewed.

Data availability statement: No data are available.

Supplemental material: This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.