Toward cervical cancer prevention and elimination in the Eastern Mediterranean Region: Current landscape and opportunities for evidence-based action.

Abstract

This review aimed to provide the first comprehensive assessment of cervical cancer prevention initiatives across the Eastern Mediterranean Region (EMR). We systematically searched PubMed on March 20, 2025, screened relevant literature, supplemented findings with WHO and HPV Information Centre data, and extracted country-level information on HPV vaccination and cervical cancer screening policies and practices in the EMR. Of 22 member countries, only eight have national HPV vaccination programs, and just seven offer cervical cancer screening, all of which are opportunistic and based on cytology, an obsolete technology. Barriers include limited public awareness, inadequate engagement of healthcare providers, and underdeveloped healthcare infrastructure. The review also highlights promising innovations such as HPV self-sampling to enhance screening accessibility and feasibility, and DNA methylation markers to improve detection accuracy and risk stratification. Cervical cancer prevention initiatives across the EMR remains insufficient. This review emphasizes the need for greater coordinated efforts to address the growing burden of cervical cancer in the region, strengthen prevention efforts, and enhance healthcare infrastructure. Bridging these gaps requires strengthened systems, expanded access, and multi-stakeholder advocacy and coordinated policies to reduce the region's cervical cancer burden.