Why standardised, evidence-based guidelines are crucial in tackling cervical cancer

Cervical cancer remains a significant health burden in low and middle-income countries, disproportionately affecting women in Southern Africa, where cases and deaths are among the highest in the world. These countries often lack official standardised screening guidelines that can motivate health workers, planners, funders and communities toward a shared goal, namely the eradication of the disease. A standardised guideline can unify training programmes, budget planning, supply chains, service delivery protocols and monitoring systems to fight cervical cancer effectively.

This alignment accelerates implementation and reduces duplication or conflicting practices across agencies and regions. Standardised screening guidelines are crucial for meeting the World Health Organisation (WHO)’s 2030 targets aimed at accelerating the elimination of cervical cancer: to vaccinate 90% of girls against human papillomavirus (HPV) by age 15, screen 70% of women with a high-performance test by ages 35 and 45 and ensure 90% of women with pre-cancer or cancer receive treatment. Meeting these measurable targets would set countries on a path to reducing the number of cases to fewer than four new cases per 100 000 women, the WHO’s benchmark for elimination of cervical cancer as a public health problem.

In the context of cervical cancer, standardised screening guidelines can shape aspirations for health outcomes, specify best practices based on scientific evidence, and build momentum and consistency across government agencies. Clear policy targets inspire action. When governments adopt ambitious, evidence-based goals, such as the WHO’s 90-70-90 targets for cervical cancer elimination, they broadcast a national aspiration.

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Policies don’t operate in a vacuum. When ministries of health, finance, education, and social welfare align around a shared, evidence-based policy, the message to providers and communities becomes consistent and compelling. We know that evidence evolves, and guidelines ensure clinical practice keeps pace.

For decades, cervical cancer screening relied on Pap smears and visual inspection methods. Today, HPV DNA testing, which directly detects the viral cause of nearly all cervical cancers, is recognised as a better primary screening method and is increasingly being introduced in national programmes. HPV testing combined with newer, less invasive treatment options for pre-cancerous growths such as thermal ablation (using heat to destroy pre-cancerous cells), offers a powerful combination to prevent progression to cancer.

In Southern Africa, introducing HPV testing into national screening services has shown promise, expanding accurate detection and linking women to earlier treatment before cancer develops. Universal HPV vaccination has now been established as a key driver for elimination. HPV vaccines prevent the infections that cause most cervical cancers, and expanding coverage dramatically reduces the number of people at risk in future generations.

Countries that embed vaccination in their national immunisation programmes, combined with screening and treatment, base their strategies on the strongest scientific evidence available. Without region-wide standardised guidelines that clearly define when and how women should be screened, and what tests should be used, programmes risk fragmentation. That inconsistency not only undermines effectiveness but also creates inequities in access and outcomes.

Standardisation ensures all women, whether in urban or rural areas, benefit from the same best practices, backed by evidence and tailored to resource realities. It also supports training and supervision, quality assurance and data systems that track progress against agreed targets. The WHO’s targets on vaccination, screening, and treatment provide both urgency and direction for national policies and also create a framework that countries can adopt to mobilise action and measure progress.

Countries that embed these targets into national cervical cancer control plans send a powerful message: elimination isn’t a distant ideal; it is a strategic priority supported by evidence and actionable milestones. Take Kenya, for example: It recently launched a multi-year cervical cancer elimination action plan explicitly aligned with WHO’s 90-70-90 framework, including integrating HPV DNA testing and expanding vaccination coverage through single-dose schedules recommended by WHO to enhance uptake and simplify delivery. Looking ahead, there are a few things that national policies must do to truly transform health outcomes in Southern Africa where cervical cancer cases and deaths are particularly high. They must:

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