More than 100 000 women in EU countries are diagnosed each year with cervical cancer (see indicator on “Cancer incidence” in Chapter 3). Cervical cancer is highly preventable if precancerous cells are detected and treated before progression occurs. The human papilloma virus (HPV) is found in over 90% of cervical cancers (European Commission, 2018), and vaccination against the main types of HPV responsible for cervical cancer is expected to reduce incidence.
European countries follow various approaches to the prevention and early diagnosis of cervical cancer. Over half of the countries have implemented population-based cervical cancer screening programmes (IARC, 2017). WHO recommends HPV vaccination for girls aged 9-13 years (WHO, 2018). Most European countries now have national HPV vaccination programmes, but the target populations vary, based on epidemiological and other evidence such as cost-effectiveness that is specific to each country (ECDC, 2014). Vaccination for boys is also considered effective when coverage for girls is low.
On average, the proportion of women in EU countries aged 20-69 years who have been screened for cervical cancer within the past three years has increased from 56% to 61% over the past decade. However, the proportion has fallen in several countries. The proportion of screened women across EU countries still varies widely, from about 25% only in Latvia and Romania to over 80% in Austria and Sweden ( 6.16).
Cancer survival is one of the key measures of the effectiveness of health care systems in managing cancer, reflecting both early detection and the effectiveness of treatment. Among women diagnosed with cervical cancer between 2010 and 2014, age-standardised five-year net survival ranged from 70% in Denmark to 54% in Latvia ( 6.17). The average among EU countries has increased from 61% to 63% over the past decade. The variation across countries has decreased, because some of the countries that had among the lowest survival have converged to some extent towards the best performers.
Trends in cervical cancer mortality rates reflect the underlying trends in incidence and survival. The mortality rates for cervical cancer have declined across EU countries from 6.0 per 100 000 women in 2000 to 5.1 in 2015 ( 6.18).
However, in many Central and Eastern European countries, cervical cancer screening rates are low, incidence has not yet declined, five-year net survival remains low and mortality is still high or even rising. These trends suggest the need for greater policy attention to prevention, early diagnosis and effective treatment for cervical cancer.
