Late Diagnosis and Limited Access to Care Fuel Gynecologic Cancer Deaths in Low- and Middle-Income Countries

Women in low- and middle-income countries face a disproportionately high burden of gynecologic cancers, including cancers of the cervix, endometrium, ovaries, vagina and vulva. A new review published in CANCER shows that major differences in survival between these countries and wealthier nations are largely linked to delayed diagnosis, inadequate screening, shortages of medical specialists and limited access to modern cancer treatment.

Researchers analyzed studies published between 2015 and 2024 and found that low- and middle-income countries account for about 94% of cervical cancer deaths worldwide. Mortality is particularly high in East Africa.

The review identified several weaknesses that contribute to poorer outcomes, including insufficient screening programs, inadequate radiotherapy capacity, shortages of trained health care professionals and restricted access to both essential and newer cancer therapies.

At the same time, the researchers point to a number of affordable interventions that could significantly reduce mortality. These include single-dose HPV vaccination, screen-and-treat programs, HPV self-sampling, expanding radiotherapy services and strengthening the medical workforce through international training partnerships.

According to the authors, these measures can be particularly effective when incorporated into national cancer-control strategies and backed by stable, long-term funding.

The researchers emphasize that the survival gap is not inevitable. In their view, much of the disparity can be addressed through earlier detection, stronger health care systems and more equitable access to effective treatment.

Dr. Alfi Sophian of the Indonesian Food and Drug Authority, the study's corresponding author, said that proven and cost-effective tools are already available. The key challenge, he noted, is securing political commitment and sustainable financing to make these interventions part of national cancer-control policies.

Suresh S. Ramalingam, editor-in-chief of CANCER and executive director of the Winship Cancer Institute of Emory University, also highlighted the potential impact of applying evidence-based approaches more consistently around the world.

The authors conclude that coordinated, system-wide reforms focused on prevention, early detection, treatment capacity and equitable access to care could save many lives and substantially narrow global disparities in gynecologic cancer survival.

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