Few women in low- and middle-income countries receive early cancer diagnosis – FemTech World

Report on Preventative Gynaecology and Alignment with Sustainable Development Goals

Introduction: Gynaecological Health and Global Development

Gynaecological cancers, including cervical, ovarian, uterine, vaginal, and vulvar, represent a significant global health challenge. Addressing this issue is central to achieving Sustainable Development Goal 3 (SDG 3), which aims to ensure healthy lives and promote well-being for all at all ages. Early detection and preventative strategies are the most effective measures for improving survival rates, reducing the need for invasive treatments, and enhancing quality of life, directly contributing to SDG 3.4, which targets a reduction in premature mortality from non-communicable diseases.

The Imperative of Early Detection for SDG 3

The correlation between early diagnosis and patient outcomes is stark. When gynaecological cancers are identified in their initial stages, the five-year survival rate exceeds 90%. This rate can decrease by more than half with late-stage diagnoses. This underscores the critical importance of proactive health measures in achieving global health targets.

Successes and Gaps in Cancer Prevention

• Cervical Cancer: Public health initiatives in England, such as the introduction of cervical screening in 1998 and the HPV vaccination program in 2008, have significantly reduced incidence and mortality. This progress exemplifies a successful model for achieving the NHS goal of eliminating cervical cancer by 2040, aligning with SDG 3.
• Endometrial Cancer: Key symptoms like postmenopausal bleeding often lead to timely medical intervention and early diagnosis.
• Diagnostic Challenges: Ovarian and vulval cancers frequently present with vague symptoms (e.g., bloating, abdominal discomfort, itching) that are often mistaken for benign conditions, leading to diagnostic delays that impede progress towards SDG 3.

A Threefold Strategy for Prevention and Early Detection

A comprehensive strategy is essential to improve early detection rates and advance gender equality in health outcomes, a key component of Sustainable Development Goal 5 (SDG 5). This strategy is built on three pillars:

1. Screening
2. Symptom Recognition
3. Lifestyle Modification

1. Screening and Vaccination

Cervical cancer prevention through HPV vaccination and screening is a public health success story. However, despite high vaccination coverage (approximately 80%), screening uptake has declined to 70% among younger women. The planned introduction of self-sampling for HPV is a strategic move to improve participation and ensure equitable access to care (SDG 3.8). For other gynaecological cancers (ovarian, uterine, vaginal, vulvar), no effective population-wide screening methods currently exist, highlighting a critical gap in preventative healthcare.

2. Symptom Recognition and Health Equity (SDG 5)

Promoting awareness of key symptoms is vital for early diagnosis. Historically, women’s gynaecological symptoms have been minimized, leading to significant diagnostic delays and reinforcing gender-based health disparities. Addressing this systemic issue is crucial for achieving SDG 5. Education, research funding, and structural support for primary care clinicians are necessary to identify early warning signs across diverse populations.

Key Warning Symptoms

• Cervical cancer: Abnormal vaginal bleeding, post-coital bleeding, unusual discharge.
• Ovarian cancer: Persistent bloating, pelvic discomfort, urinary urgency, loss of appetite, weight loss.
• Uterine cancer: Postmenopausal bleeding, irregular or heavy periods.
• Vaginal cancer: Unusual bleeding or discharge.
• Vulvar cancer: Itching, pain, lumps, or ulceration.

3. Lifestyle and Risk Reduction

Empowering individuals with knowledge to make healthy lifestyle choices is a cornerstone of preventative health and contributes directly to SDG 3. Risk reduction strategies include:

• Maintaining a healthy weight and consuming a nutrient-rich diet.
• Avoiding tobacco and limiting alcohol consumption.
• Receiving the HPV vaccination and practicing safe sex.
• Attending regular health checks and managing chronic conditions.
• Seeking genetic counselling for relevant family medical histories.

Systemic Enablers for Progress

The Role of Men and Partners

Preventative gynaecology is a societal issue, not one confined to women. Engaging men and partners is essential for fostering supportive environments where health concerns can be discussed openly. Inclusive awareness campaigns that challenge stigma contribute to gender equality (SDG 5) by promoting shared responsibility in health.

The Rise of FemTech

Technological innovation is transforming preventative gynaecology. FemTech solutions such as menstrual tracking apps, wearable hormone monitors, and AI-powered symptom tools empower individuals with greater insight into their health. However, technology must be integrated with systemic changes that ensure symptoms are recognized and addressed promptly by healthcare systems.

Empowering Through Self-Advocacy

Self-advocacy is fundamental to preventative gynaecology and personal empowerment, aligning with the principles of SDG 5. This involves individuals knowing their bodies, tracking symptoms, and demanding respectful and informed medical care. This empowerment helps to counteract the historical dismissal of women’s health concerns.

Future Directives for Multi-Stakeholder Action

Achieving a future where early detection is the norm requires collaborative action from all sectors of society.

Recommendations

• For Individuals: Utilize digital tools to monitor health trends and use this data to facilitate informed conversations with healthcare providers.
• For Clinicians: Integrate new technologies into practice and proactively inquire about menstrual, hormonal, and sexual health.
• For Innovators: Design inclusive and accessible FemTech tools that serve diverse populations, regardless of age, ethnicity, or background.
• For Policymakers and Researchers: Allocate funding to research focused on earlier detection, improved diagnostics, and equitable access to care, thereby advancing progress towards SDG 3 and SDG 5.

Analysis of Sustainable Development Goals in the Article

1. SDGs Addressed or Connected to the Issues

   The article on preventative gynaecology addresses several Sustainable Development Goals (SDGs) by focusing on health, gender equality, and technological innovation.

   • SDG 3: Good Health and Well-being

     This is the most prominent SDG in the article. The entire text is dedicated to improving health outcomes related to gynaecological cancers through prevention, early detection, and treatment. It discusses mortality rates, the importance of screening and vaccination (like the HPV vaccine), and access to healthcare services, all of which are central to SDG 3.

   • SDG 5: Gender Equality

     The article connects directly to gender equality by highlighting health issues that exclusively or disproportionately affect women. It points out systemic issues, such as how “women’s gynaecological symptoms have often been minimised or dismissed,” leading to diagnostic delays. It calls for empowering women through self-advocacy and ensuring they receive “respectful, informed care,” which aligns with the goal of eliminating discrimination and ensuring women’s full participation in decisions affecting their health.

   • SDG 9: Industry, Innovation, and Infrastructure

     This SDG is relevant due to the article’s emphasis on the role of technology and research in advancing preventative gynaecology. The section on “The Rise of FemTech” explicitly mentions innovations like “menstrual tracking apps, wearable hormone monitors, at-home diagnostics, and AI-powered symptom tools.” The call for policymakers and researchers to “support funding for research that focuses on earlier detection, better diagnostics, and equitable access to care” also supports the innovation and research aspect of SDG 9.

2. Specific Targets Identified

   Based on the article’s content, several specific targets under the identified SDGs can be pinpointed.

   • Targets under SDG 3: Good Health and Well-being

     • Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
       
       Explanation: The article’s core focus is on reducing mortality from gynaecological cancers (non-communicable diseases) through prevention strategies like lifestyle changes and early detection. It states that when detected early, “the five-year survival rate exceeds 90 per cent,” directly linking prevention and early treatment to reducing premature mortality.
     • Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
       
       Explanation: The discussion on cervical screening programs, HPV vaccination, and the importance of regular gynaecological check-ups are all components of sexual and reproductive healthcare services. The mention of NHS England’s goal to “eliminate cervical cancer by 2040” is an example of integrating reproductive health into a national strategy.
     • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
       
       Explanation: The article advocates for “equitable access to care” and highlights the importance of vaccination programs (HPV vaccine) and screening, which are key elements of universal health coverage. The introduction of “self-sampling for HPV” is mentioned as a way to improve participation and access.

   • Targets under SDG 5: Gender Equality

     • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
       
       Explanation: This target is closely related to SDG 3.7 but from a gender equality perspective. The article’s call to overcome the historical dismissal of women’s gynaecological symptoms and to empower women through self-advocacy (“push for answers when something feels ‘off’”) is about ensuring women can exercise their right to health and make informed decisions about their bodies.

   • Targets under SDG 9: Industry, Innovation, and Infrastructure

     • Target 9.5: Enhance scientific research, upgrade the technological capabilities of industrial sectors in all countries, in particular developing countries, including, by 2030, encouraging innovation and substantially increasing the number of research and development workers per 1 million people and public and private research and development spending.
       
       Explanation: The article highlights the role of “FemTech” and calls on innovators to “design inclusive, accessible tools.” It also explicitly asks policymakers and researchers to “support funding for research that focuses on earlier detection, better diagnostics,” which directly aligns with enhancing scientific research and encouraging innovation in the health sector.

3. Indicators Mentioned or Implied

   The article provides several quantitative and qualitative indicators that can be used to measure progress towards the identified targets.

   • Five-year survival rate for early-detected gynaecological cancers: The article states this “exceeds 90 per cent.” This is a direct indicator for Target 3.4, measuring the effectiveness of early detection and treatment in reducing mortality from non-communicable diseases.
   • HPV vaccination coverage: Mentioned as “approximately 80 per cent.” This is a key performance indicator for Targets 3.7 and 3.8, measuring the reach of preventative healthcare services.
   • Cervical screening uptake rate: The article notes a decline, “particularly among younger women, where participation has dropped to 70 per cent.” This indicator measures access to and utilization of essential screening services under Targets 3.7 and 3.8.
   • Incidence and mortality rates of cervical cancer: The article implies a reduction in these rates due to screening and vaccination introduced in 1998 and 2008, respectively. This is a primary indicator for Target 3.4.
   • Average time to diagnosis for gynaecological conditions: The article cites that endometriosis “still takes nearly 9 years on average to diagnose.” This is a powerful indicator for Target 5.6, highlighting systemic delays and the dismissal of women’s health issues. A reduction in this time would indicate progress.
   • Development and adoption of FemTech tools: The mention of “menstrual tracking apps, wearable hormone monitors, at-home diagnostics, AI-powered symptom tools” serves as a qualitative indicator for Target 9.5, showing progress in technological innovation for health.
   • Funding for gynaecological research: The call to “support funding for research” implies that the level of public and private R&D spending is a critical indicator for Target 9.5.

4. Table of SDGs, Targets, and Indicators

   SDGs	Targets	Indicators
   SDG 3: Good Health and Well-being	3.4: Reduce premature mortality from non-communicable diseases (NCDs) through prevention and treatment.	Five-year survival rate for early-detected cancers (exceeds 90%). Incidence and mortality rates associated with cervical cancer.
   SDG 3: Good Health and Well-being	3.7 & 3.8: Ensure universal access to sexual and reproductive health-care services and achieve universal health coverage.	HPV vaccination coverage rate (approx. 80%). Cervical screening uptake rate (declined to 70% in younger women). Availability of new methods like self-sampling for HPV.
   SDG 5: Gender Equality	5.6: Ensure universal access to sexual and reproductive health and reproductive rights.	Average time to diagnose conditions like endometriosis (nearly 9 years). Qualitative evidence of women’s symptoms being dismissed or minimized.
   SDG 9: Industry, Innovation, and Infrastructure	9.5: Enhance scientific research and upgrade technological capabilities.	Development and availability of FemTech tools (e.g., tracking apps, at-home diagnostics). Level of public and private funding for research into earlier detection and diagnostics.

Source: femtechworld.co.uk