Cervical precancer treatment in women living with HIV

Export Indicator

Percentage of women living with HIV who screened positive for cervical precancer who received treatment for precancerous lesions in the last 12 months
What it measures

Progress towards the treatment coverage target of 90% of women with a positive screening test, receiving treatment.

Rationale

The purpose of this indicator is to assess availability, access and coverage of precancer treatment among women living with HIV who were diagnosed with precancerous lesions upon screening and were deemed eligible for precancer treatment in line with the World Health Organization (WHO) Recommendations for screening and treatment to prevent cervical cancer.

The WHO Global Strategy targets to eliminate cervical cancer are to vaccinate 90% of eligible girls against human papillomavirus (HPV), to screen 70% of eligible women at least twice in their lifetimes and to effectively treat 90% of those with a positive screening test or a cervical lesion, including palliative care when needed, all by 2030.

Numerator

Number of women living with HIV who received treatment for cervical precancerous lesions after screening positive for cervical precancer.

Denominator

Number of women living with HIV who screened positive for cervical precancer

Calculation

Numerator/denominator

Method of measurement

The numerator and denominator are generated from programmatic data from HIV or cervical cancer screening programmes. Women who screened positive, but were ineligible for treatment of precancerous lesions, for example because they were referred for evaluation of potential invasive cervical cancer, should not be counted.

Measurement frequency

Annual

Disaggregation
  • Age (15-19, 20-24, 25-29, 30-49, 50+ years).
  • Cervical precancer treatment episode (1st in lifetime, 2nd, 3rd, 4th, etc.).
  • Treatment method received (cryotherapy, thermal ablation, large-loop excision of the transformation zone [LLETZ], other).
  • Cities and other administrative areas of epidemiologic importance.
Additional information requested

Please provide city-specific and other subnational data for this indicator. Space has been created in the data entry sheet to provide information for the capital city and one or two other key administrative areas of high epidemiological relevance, such as those with the highest HIV burden or cities that have committed to ending AIDS by 2030.

Strengths and weaknesses

Variation in the denominator over time may reflect the changing skill of healthcare workers to evaluate eligibility for precancerous treatment, the screening test used and its accuracy, and whether a triage test is used.

Further information

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71:209-249.

Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: World Health Organization; 2020 (https://www.who.int/publications/i/item/9789240014107).

Comprehensive cervical cancer control: a guide to essential practice. 2nd ed. Geneva: World Health Organization; 2014 (https://apps.who.int/iris/bitstream/handle/10665/144785/9789241548953_eng.pdf).

Guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. Geneva: World Health Organization; 2021 (https://www.who.int/publications/i/item/9789240030824).

WHO technical guidance and specifications of medical devices for screening and treatment of precancerous lesions in the prevention of cervical cancer. Geneva: World Health Organization; 2020 (https://www.who.int/publications/i/item/9789240002630).