Early Detection and Prevention Saves Lives
Jhpiego believes in a world in which an integrated and coordinated response to women’s cancer detects disease early and ends preventable deaths.
Jhpiego’s legacy of working in women’s cancers started in the 1990s with pioneering early clinical trials on visual inspection with acetic acid (VIA) for identification of precancerous lesions in the cervix and expanded to address access to and technical implementation of primary prevention, early detection and treatment for both breast and cervical cancer. Jhpiego believes in taking an ecosystem approach to women’s cancers—working with partner governments, global technical bodies and the private sector to bring a coordinated and resourced response to prevention, detection and treatment.
Our guiding principles for women’s cancer:
- Lead with equity-based programming that addresses the systemic barriers and ensures equal access to health care services
- Build robust data governance that generates evidence to show level of impact and inform iterative design
- Innovate and design programs grounded on a woman-centered approach to ensure respectful and responsive services based on needs and values
- Build sustainably from the beginning, partnering with local stakeholders to build the foundations that will be scalable in the country
- Pave the pathway for more efficient channels for investment and innovation, balancing exploration and scalability
Breast cancer is the most commonly diagnosed cancer in women, with more than 2.2 million newly diagnosed in 2020, and is the leading cause of cancer deaths in women, with more than 685,000 deaths in 2020. In low- and middle-income countries, breast cancer is often diagnosed very late, which increases mortality rates. The World Health Organization promotes early detection to improve breast cancer outcomes and survival.
How We Make an Impact
- Introducing and expanding programs that promote early detection and diagnosis of breast cancer in Botswana, Mozambique, Ethiopia, Tanzania and India
- Working to increase access to clinical breast examinations at the primary health care level and breast health awareness among communities and providers
- Building strong referral pathways to diagnostics and treatment
- Working with governments to shore up the capacity for diagnosis (diagnostic imaging and pathology) and treatment
Cervical cancer is preventable and treatable if diagnosed early, but it remains one of the most common cancers in women worldwide. Close to 9 of every 10 cases occur in low- and middle-income countries. Most cervical cancers are caused by the human papillomavirus (HPV), a common sexually transmitted infection that can be prevented with the HPV vaccine. In the last 5 years, nearly half a million women worldwide benefited from Jhpiego’s cervical cancer prevention services, which include low-cost, effective screening and treatment.
In July 2021, The World Health Organization released new guidelines for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. It now recommends an HPV DNA based test, which is more sensitive and reliable for the detection of cervical precancer than Pap testing and VIA.
Preventing Cervical Cancer: Jhpiego innovates to save lives
Jhpiego is helping countries prevent and eliminate cervical cancer. To do so, we’ve embraced a range of bold, transformative strategies and solutions, such as introducing newer technologies and designing woman-centered, integrated services within the framework of primary health care. We also develop training programs to provide learning and practice opportunities that health workers need to develop competency to deliver high-quality cervical cancer prevention services, including using HPV testing for screening and thermal ablation for treatment.Read Our Briefer Access Our HPV Testing & Thermal Ablation Clinical Training Package
More than 311,000 women each year die due to cervical cancer. Most of these women live in low- and middle-income countries.
A Ticket to Health
Bright pink is the color of a ticket to cervical health for girls in Tanzania, signifying receipt of a safe, affordable vaccine that protects against many of the strains of HPV that commonly cause cervical cancer. Today, young girls like Hadija and Neema are protected.
How We Make an Impact
We are actively involved in global and country-level efforts to expand HPV vaccinations to protect girls from cervical cancer and improve the health of adolescents. In 2017, in partnership with Gavi, the Vaccine Alliance, Jhpiego began supporting the governments of India and Pakistan in their decision-making process toward introduction of the HPV vaccination into public-sector health programs. In Tanzania and Ethiopia, Jhpiego supports the ministries of health to roll out national HPV immunization programs. In 2019, Jhpiego received Gavi funds to provide technical assistance for the preparation and rollout of national HPV vaccination programs in Liberia, Zambia and Côte d’Ivoire.
We work with ministries of health and other stakeholders to implement national screen-and-treat programs that efficiently employ the latest technologies in a timely fashion. Along with our partners, we pioneered the single visit approach (SVA), a clinically safe, acceptable and effective approach to cervical cancer prevention for low-resource settings. The SVA consists of visual inspection using vinegar or dilute acetic acid (VIA) to detect precancerous lesions on the cervix, followed by the offer for treatment using cryotherapy (a freezing technique) for precancerous lesions—all in the same visit.
Jhpiego is now helping countries scale up the World Health Organization’s recommended screen-and-treat approach that includes screening women ages 30–49 with an HPV test. For women with a positive, high-risk HPV result, screening is followed by visual inspection of the cervix to determine whether she should be treated or referred to another facility.
With the introduction of HPV testing, only women with a positive, high-risk HPV result require VIA to determine the type of treatment, which reduces the workload and patient volume in clinics. To increase the number of women who get screened, Jhpiego conducted an HPV self-screening study in Botswana, where cervical cancer is the leading cause of cancer and cancer-related deaths among women. The study results strongly point to the feasibility and acceptability of HPV self-testing and high treatment rates for women with positive HPV results.
Through Unitaid’s global Scale Up Cervical Cancer Elimination with Secondary Prevention Strategy (SUCCESS, 2019–2022) project in Burkina Faso, Côte d’Ivoire, Guatemala and the Philippines, Jhpiego is currently supporting ministries of health to expand integrated HPV testing approaches and the use of thermal ablation in reproductive health and HIV service delivery settings. SUCCESS is also engaging with networks of professional associations, cancer societies and civil society organizations to increase demand and advocate for the adoption and use of appropriate technologies for elimination of precancerous lesions (e.g., thermal ablation).
Because of advances in HIV treatment, women are now living with HIV but are at risk of dying of cervical cancer due to the lack of screening. Women infected with HIV are six times more likely than the general population to be diagnosed with cervical cancer. Building on our experience establishing and scaling up cervical cancer screening and treatment programs, we are integrating cervical cancer prevention programs with HIV care and treatment services and family planning programs to increase access to these services.
Based on our work over the last 10 years to improve documentation, data collection, analysis and use, Jhpiego led the development of the patient and program monitoring and the facility-based surveys sections in the World Health Organization’s 2019 Improving data for decision-making: a toolkit for cervical cancer prevention and control programmes, which focuses on low- and middle-income countries.