The WHO European Region is getting closer to a future in which women do not die of cervical cancer. With greater efforts to increase vaccination against human papillomavirus (HPV) and cervical cancer screening and treatment, that future could arrive much sooner, saving the lives of many more young women in the coming years.
“Eliminating cervical cancer is no longer a distant dream – it is a tangible goal within reach for the WHO European Region. January is cervical cancer awareness month and an opportunity to recognize the relentless efforts and significant advancements in HPV vaccination, thanks to which the path to elimination is clearer than ever.
As the father of two daughters, this progress is deeply meaningful to me, knowing that future generations of women will be better protected from this preventable disease. But we must move faster. By vaccinating more adolescents and screening more women, we can save many lives in years ahead,” explains Dr Hans Henri P. Kluge, WHO Regional Director for Europe.
Milestones and momentum
- Every year more countries in the Region include HPV vaccination in their routine immunization programmes. With the addition of Kazakhstan in 2024, 47 of 53 countries now offer HPV vaccination to adolescent girls. Kosovo* also introduced the vaccine in 2024.
- Including boys in HPV vaccination programmes increases impact, both on cervical cancer among women, thanks to herd immunity, and on other types of cancer and genital warts among both men and women. Currently, 39 countries in the Region now offer HPV vaccination to boys and girls.
- Some counties have achieved and maintained high vaccination coverage, including Portugal, where vaccination was introduced in 2008, and coverage with at least one dose among girls has remained consistently above 90%.
This progress has impact. Studies in several countries in the European Region with high vaccination uptake have identified:
- up to 90% reduction in infections with high-risk HPV types (16 and 18) in age groups targeted by national immunization programmes;
- up to 70% reduction in pre-cancer risk in young women compared to the pre-vaccine era;
- dramatic declines in the incidence of invasive cervical cancer in young women compared to the period before vaccination – for example, studies conducted in Finland and the United Kingdom (Scotland) found no cases of cervical cancer among young women who were vaccinated against HPV at 12–13 years of age.
Unfortunately, vaccination uptake in many countries remains well below the 90% target. In 2023, HPV vaccination rates for boys in the Region rose significantly, climbing from just 1% in 2018 to 16%; however, coverage for girls increased only slightly, from 27% to 30% over the same period.
“HPV vaccination is incredibly safe and effective. We must provide timely protection to ensure that no more women lose their lives, their health or their fertility to a preventable cancer,” adds Dr Kluge.
Prevention, detection and treatment
The impact of HPV vaccination is visible in stages. In the first years following widespread uptake of HPV vaccination, countries see a decrease in the rate of HPV infections among teenagers and young adults. This is followed by a decrease in the rate of pre-cancerous lesions among young women caused by persistent HPV infection.
It typically takes several years or even decades for pre-cancerous lesions to develop into cervical cancer, so it can take one or more decades before the impact of vaccination on cervical cancer incidence becomes visible. Vaccination cannot prevent 100% of cases, so cervical cancer screening remains vital for early detection of any cases that may still develop.
Screening can detect precancerous lesions before they progress to cancer, enabling timely treatment and preventing cancer development. According to 2023 data, 37 out of 53 Member States in the WHO European Region have implemented organized population-based screening programmes. However, only 15 of these reach a coverage of 70% or higher. Ensuring that high-quality cervical cancer screening programmes are part of patient care pathways, including diagnosis and treatment, is essential.
Persistent HPV infection can lead to cervical cancer, which poses a serious public health problem. According to WHO estimates for 2022, each year in the European Region about 60 000 women are newly diagnosed with cervical cancer and more than 32 000 die from this preventable disease. WHO supports a comprehensive approach to preventing, detecting and treating cervical cancer.
Vaccines for preventing high-risk HPV types and offering cross-protection against HPV types not included in the vaccines, have been available since 2006. Since then, over 500 million doses of HPV vaccines have been distributed, and studies on HPV vaccine safety involving several million people have assessed a wide range of health outcomes. None of these studies have identified any safety concerns.
Looking ahead
The “Roadmap to accelerate the elimination of cervical cancer as a public health problem in the WHO European Region 2022–2030” outlines priority actions to guide Member States in reaching the 2030 targets – the “90-70-90 targets” – set by the Cervical Cancer Elimination Initiative:
- 90% of girls fully vaccinated with the HPV vaccine by age 15;
- 70% of women screened using a high-performance test by age 35, and again by age 45;
- 90% of women identified with cervical disease receive treatment (90% of women with precancer treated, and 90% of women with invasive cancer managed).
Increased efforts are needed in every country to identify and remove barriers to HPV vaccination, cervical cancer screening and quality treatment. As outlined in the roadmap, for vaccination these include initiating steps for evidence-informed decision-making on the introduction of HPV vaccine (in countries without an HPV vaccination programme); developing catch-up vaccination strategies; ensuring vaccination services are tailored to meet the needs of the target population, including hard-to-reach groups; and building capacity of health-care workers on how to communicate with young people and parents about the HPV vaccine.
* In accordance with United Nations Security Council resolution 1244 (1999).