Conclusion
Cervical cancer is endemic in sub-Saharan Africa and other parts of the developing world, that are least prepared to deal with a high burden of disease. The current methods of screening and treatment for cervical dysplasia and invasive cancer have clearly not achieved the same results in the developing world as they have done in the developed world towards reducing the burden of this disease. With up to nine out of 10 cervical cancer cases and deaths occurring in LMICs 2 and the disease being the most commonly diagnosed cancer in 28 of these countries and the leading cause of cancer death in 42 countries5, it has become imperative that innovative ways of dealing with the problem of cervical cancer in sub-Saharan Africa and the developing world are found. Ideally this innovative approach would address the limitations posed by the current methods of treatment for cervical dysplasia, as well as being able to be integrated into the existing VIA screen and treat strategy used in this region, which negates the need for trained clinicians and expensive medical infrastructure. An ideal locoregional therapy for HPV-induced cervical lesions to be used in this setting would be a cytotoxic anticancer agent which would target the pre-neoplastic lesion with high selectivity for diseased epithelium and non-toxic to normal tissue and low systemic absorption. The anticancer agent must be readily available, safe to use in women of child-bearing age and effective. The formulation would be self-administered with increased residence time at the cervix and therefore require a minimum number of applications, for it to be acceptable to patients. In this growing area of research, developing a drug-based locoregional treatment for cervical dysplasia which can be administered at the time of screening by a nurse or even by the patient themselves and with no requirement for specialized equipment, could prove to be the game-changer that sub-Saharan Africa so desperately needs in the fight against cervical cancer.