How can we reduce gynecologic cancer–related deaths in low- and middle-income countries?

Low- and middle-income countries (LMICs) bear a disproportionate burden of gynecologic malignancies—cancers of the cervix, endometrium, ovary, vagina, and vulva. A review published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society, reveals that survival disparities for these cancers are driven by late-stage diagnosis, limited screening coverage, inadequate radiotherapy infrastructure, workforce shortages, and restricted access to essential and novel therapies.

By analyzing studies published between 2015 and 2024, investigators observed that LMICs account for approximately 94% of global cervical cancer deaths, with the highest mortality observed in East Africa. Despite persistent survival disparities in LMICs, research has generated evidence that cost-effective and scalable interventions—including single-dose HPV vaccination, screen-and-treat strategies, HPV self-sampling, radiotherapy expansion, and workforce development with international training partnerships—can substantially improve outcomes when embedded within national cancer control policies and supported by sustainable financing mechanisms.

The authors stressed that policy-driven, system-level reforms should prioritize prevention, strengthen service delivery, and expand equitable access to care.

“The survival gap in gynecologic cancers between low- and middle-income countries and wealthier nations is not inevitable—it is largely the result of delayed diagnosis and under-resourced health systems,” said corresponding author Dr. Alfi Sophian, SSi, MSi, of the Indonesian Food and Drug Authority. “Our review shows that proven, cost-effective interventions already exist. What is needed now is stronger political commitment and sustainable financing to embed them into national cancer control policies.”

CANCER’s Editor-in-Chief, Suresh S. Ramalingam, MD, FASCO, who is the Executive Director of the Winship Cancer Institute of Emory University and the Roberto C. Goizueta Chair in Cancer Research at the Emory University School of Medicine, agreed that the review highlights key opportunities to reduce the burden of gynecological malignancies in low- and middle-income countries. “Gynecological malignancies claim the lives of far too many women globally; implementation of evidence-based tools consistently and uniformly across the world will save numerous lives,” he said.

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Full Citation:
“Gynecologic Cancers in Low- and Middle-Income Countries: Bridging the Survival Gap.” Dewi Setiawati, Wachyudi Muchsin, and Alfi Sophian. CANCER; Published Online: August 24, 2026 (DOI: 10.1002/cncr.70518).

URL: http://doi.wiley.com/10.1002/cncr.70518

About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online. Follow CANCER on X @JournalCancer, and stay up to date with the American Cancer Society Journals on Instagram, LinkedIn, and YouTube.

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