**1. Introduction**

230 Cancer Prevention – From Mechanisms to Translational Benefits

World Cancer Research Fund & American Institute for Cancer Research (2007d). Summary,

Zeeb, H. & Greinert, R. (2010). The role of vitamin D in cancer prevention: does UV

Ziech, D.; Franco, R.; Georgakilas, A.G.; Georgakila, S.; Malamou-Mitsi, V.; Schoneveld, O.;

*Chem Biol Interact,* Vol. 188, No. 2, pp. 334-339, ISSN 1872-7786

ISBN-13: 9780972252225, Washington DC, USA

Vol. 107, No. 37, pp. 638-643, ISSN 1866-0452

In: *Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective*, World Cancer Research Fund, pp. xiv-xxi, American Institute for Cancer Research,

protection conflict with the need to raise low levels of vitamin D? *Dtsch Arztebl Int,*

Pappa, A. & Panayiotidis, M.I. (2010). The role of reactive oxygen species and oxidative stress in environmental carcinogenesis and biomarker development.

> Cervical cancer ranks as the third most common cancer in women worldwide and is the fourth leading cause of cancer deaths in women, with an estimated 270,000 deaths annually. Over 85% of both cervical cancer cases and deaths occur in developing countries with only 5% of global cancer resources (Lancet 2010). Cervical cancer is the most common cancer in women in most developing countries and most common cause of cancer deaths (Cervical Cancer Action: Report Card 2011). It is the leading cause of years of life lost to cancer in low resource settings (Yang et al. 2004). In sub-Saharan Africa cervical cancer represents 22% of all cancers in women (Parkin et al. 2003).

> Currently, an estimated 33.3 million individuals worldwide are living with HIV/AIDS, approximately 68% of whom live in Sub-Saharan Africa; globally over 50% of all those living with HIV are female and in Sub-Saharan Africa, women account for 60% of HIV infections. In 2009 there were an estimated 7000 new infections per day, 51% of these among women (UNAIDS 2010). However, there have been dramatic advances in prevention, care and treatment in the areas that are hardest hit by HIV over the past 10 years, coincident with unprecedented global commitment for funding and other support. These include a global decline of 19% in number of new HIV infections and a >25% decline in HIV prevalence among young people 15–24 years of age in 15 high burden countries, a decrease in global AIDS deaths by 19% from 2004–2009, and an increase in access to antiretroviral therapy (ART) in low and middle-income (LMIC) countries from 400,000 in 2003 to 5.25 million by the end of 2009 (this however, comprises only 35% of those estimated to be in need of therapy) (WHO 2011).

> The areas where cervical cancer rates are highest also often have high prevalence of HIV and the presence of HIV increases the risk of cervical precancerous and cancerous changes; furthermore there is general unavailability of effective cervical cancer screening programs in these lower resource settings. This paper will review issues related to cervical cancer screening and prevention for HIV-infected women in low resource settings, with a focus on non-cytology-based techniques.
