Cervical cancer prevention in settings of high HIV prevalence

Abstract

Despite being a preventable disease, cervical cancer is still the second most common cancer in women worldwide. HIV infection is associated with a higher incidence, more rapid progression, and increased recurrence rates of human papillomavirus (HPV)-associated cervical intra-epithelial neoplasia and invasive cancer. The disease burden in developing countries is the result of inadequate national health care infrastructures that cannot establish or sustain comprehensive screening programmes, together with a high prevalence of HIV infection, particularly in southern Africa. In this article, clinically relevant issues for primary prevention of cervical lesions by a quadrivalent HPV vaccine and the ‘screen-and-treat’ protocol in settings of high HIV prevalence will be explored.