Advancing Cervical Cancer Care: SGO Leads Three Landmark Consensus Statements Supporting the WHO Elimination Initiative

The Society of Gynecologic Oncology (SGO) and its Cervical Cancer Taskforce led the concurrent publication of three consensus papers in Gynecologic Oncology, each developed in collaboration with leading national organizations. These publications define minimum standards of care for cervical cancer prevention and treatment in the United States and chart a unified course toward the World Health Organization’s (WHO) Cervical Cancer Elimination goals. 

The manuscripts, endorsed by the American Society for Radiation Oncology (ASTRO), American Brachytherapy Society (ABS), and American Society for Colposcopy and Cervical Pathology (ASCCP), and supported by the American College of Obstetricians and Gynecologists (ACOG), represent a large multi-society effort. Their simultaneous release underscores the urgency of equitable access to high-quality cervical cancer care and the collective commitment to reduce preventable deaths worldwide . 

“We have finally seen advances in cervical cancer treatment that result in improved survival, yet a large proportion of our patients are not even receiving treatment that reaches the standards established decades ago,” said Deanna Teoh, MD, MS, FACOG, Co-chair of the SGO Cervical Cancer Taskforce and Associate Professor at the University of Minnesota. “These papers establish minimum treatment standards that all patients should receive based on evidence-based medicine and irrespective of sociodemographic status.”  

Embracing and Implementing the WHO Cervical Cancer Elimination Campaign Goals 

(Endorsed by SGO, ASCCP, ASTRO, and ABS, and supported by ACOG) 

This paper provides a foundational roadmap for achieving WHO’s 90-70-90 targets: 

• 90% of girls fully vaccinated against HPV by age 15 

• 70% of women screened by ages 35 and 45 

• 90% of women with pre-cancer or invasive cancer managed with evidence-based treatment 

The authors outline standardized, evidence-based care practices to eliminate inequities in diagnosis, treatment, and outcomes across the U.S. healthcare system. The paper emphasizes timely pathology testing, multidisciplinary treatment coordination, care initiation (within four weeks of diagnosis), equitable access to imaging and surgery, and treatment by gynecologic oncologists whenever possible. 

Key recommendations include: 

• Ensuring all cervical cancer patients have access to PD-L1 testing and appropriate biomarker-driven therapies 

• Standardizing staging and imaging practices to improve diagnostic accuracy 

• Promoting fertility-sparing treatment options where appropriate 

• Establishing treatment initiation benchmarks to minimize mortality risk from delays 

These evidence-based standards aim to harmonize care delivery nationwide, ensuring that geography, insurance status, or race no longer determine outcomes. 

Health Equity, Disparities, and Barriers to Cervical Cancer Care in the U.S. 

(Endorsed by SGO, ASCCP, ASTRO, and ABS, and supported by ACOG) 

This companion paper examines the social determinants of health (SDOH) that drive disparities in cervical cancer prevention and outcomes. Authors highlight, that despite medical advances, cervical cancer incidence and mortality remain disproportionately high among Black, Hispanic, rural, and underinsured populations. 

The paper details systemic factors, such as inconsistent insurance coverage and limited access to specialty providers and diagnostic imaging, that hinder equitable care. For example, delays in completing therapy beyond 56 days are linked to higher mortality rates, disproportionately affecting Black and Hispanic women. 

The taskforce calls for: 

• Strengthening public insurance programs and optimizing Medicaid access 

• Investing in community-level outreach and navigation programs 

• Expanding clinical trial inclusion for underrepresented groups 

• Utilizing models like the U.S. Military Health System and state-level initiatives (e.g., Cervical Cancer Free North Carolina) to reduce disparities  

These strategies can transform cervical cancer outcomes by addressing the root causes of inequity, not just clinical manifestations. 

Minimum Standards for Radiation Therapy in the Treatment of Cervical Cancer in the U.S. 

(Endorsed by SGO, ASTRO, and ABS) 

Radiation therapy remains central to curative treatment for cervical cancer, yet access and quality vary widely across the U.S. This statement defines minimum and advanced standards for radiation therapy delivery, reinforcing its role as a critical benchmark of quality care. 

Highlights include: 

• Establishing Intensity-Modulated Radiation Therapy (IMRT) as the minimum standard for adjuvant treatment delivery 

• Reaffirming brachytherapy as an essential component of care for locally advanced cervical cancer (LACC), with no acceptable substitutes 

• Recommending timely completion of radiation within 56 days to maximize survival outcomes 

• Expanding access to palliative radiation as a measure of equity in care delivery 

As the authors note, even with technological advances such as image-guided brachytherapy and immunotherapy combinations, “broad access to timely, high-quality radiation therapy must be considered a necessary part of equitable cervical cancer care.”  

 A United Front to Eliminate Cervical Cancer 

 The SGO Cervical Cancer Taskforce directly supports WHO’s global elimination strategy by unifying the expertise of leading medical societies to standardize and communicate care practices through these publications. “As continued decreases in safety-net funding occur, it will become increasingly important for the gynecologic oncology community to advocate for these effective treatments for all patients who suffer with cervix cancer,” Dr. Teoh emphasized. “These three papers provide a roadmap for the work we have ahead of us.”  

To hear more from the authors, listen to the Gynecologic Oncology podcast discussion hosted by Deputy Editor Warner Huh, MD, FACOG, FACS, featuring taskforce members Junzo Chino, MD, FASTRO, FABS, Charles “Trey” Leath, III, MD, MSPH, FACS, FACOG, Nancy Zhou, MD, and Shane Neibart, MD, MS.