Cervical cancer in the Caribbean, the preventable cancer that is still killing too many women

January is Cervical Cancer Awareness Month, a useful moment for the Caribbean to look past the slogans and measure the gap between what is medically possible and what is happening on the ground. Cervical cancer is one of the most preventable cancers, yet it remains a major cause of death for women in many Caribbean countries, driven by uneven HPV vaccination, low or inconsistent screening, delays in follow-up, and limited access to treatment.

Globally, cervical cancer caused about 660,000 new cases and 350,000 deaths in 2022, and more than 95% of cases are linked to persistent infection with human papillomavirus (HPV). The burden is heaviest in low- and middle-income countries, where health system access and continuity of care are often weakest, and where women living with HIV face substantially higher risk, estimated by WHO at six times higher than women without HIV.

What the numbers say about the Caribbean

The most recent consolidated regional estimates from the International Agency for Research on Cancer (IARC), using GLOBOCAN 2022 data (published February 2024), point to a real Caribbean burden that is often under-discussed.

Across the Caribbean subregion, cervical cancer was estimated at 4,012 new cases and 2,397 deaths in 2022. In the same dataset, the age-standardized rate (world) for cervical cancer in the Caribbean is shown at 12.0 per 100,000 women for incidence and 7.7 per 100,000 for mortality, a signal that too many women are still being diagnosed late or not reaching effective treatment fast enough.

PAHO’s most recent regional situation summary (published September 2024) frames the wider context: the Americas overall have an age-adjusted incidence of 11.5 per 100,000 women, with a stark split between North America (6.4) and Latin America and the Caribbean (15.1). In other words, the Caribbean sits in the higher-burden half of the hemisphere, and country variation is wide.

A closer look, country snapshots that show how uneven the burden is

Because the Caribbean is not one health system, averages can hide extremes. Even within the same GLOBOCAN 2022 framework, country profiles show big differences in estimated cases, deaths, and risk.

Haiti stands out for scale and severity: 869 new cervical cancer cases and 451 deaths were estimated in 2022, and cervical cancer ranked among the leading cancers affecting Haitian women.

In Jamaica, the estimate for 2022 was 376 new cases and 236 deaths, again indicating that a large share of women are still dying from a cancer that can often be prevented or cured when caught early.

In Trinidad and Tobago, the 2022 estimate was 192 new cases and 122 deaths.

These figures are estimates, not perfect counts, and that limitation matters. Many Caribbean territories still struggle with complete cancer registration and timely reporting, which is why CARPHA and partners have pushed to strengthen population-based cancer registries and data quality through the IARC Caribbean Cancer Registry Hub.

Why cervical cancer stays high in the Caribbean

1) HPV vaccination gaps are still wide

Vaccination is the first line of defense, and PAHO reports that 32 of 35 countries in the Americas have introduced HPV vaccine in national immunization programs. Coverage, however, is the real test, and it varies dramatically. PAHO reports first-dose coverage ranging from 1% in Grenada to 88% in Chile (2023).

PAHO also notes a policy shift that could help smaller systems catch up: as of 2024, 21 countries in the Americas had introduced single-dose HPV vaccine schemes, which can reduce program costs and logistical drop-off, while still protecting girls before HPV exposure.

2) Screening is often too late, too inconsistent, or hard to complete

Screening is where many Caribbean systems lose women, not because the science is unclear, but because the pathway from screening to diagnosis to treatment is fragile.

PAHO reports that screening coverage in the region ranges from 7% in Haiti to 87% in Canada, and even where coverage looks “high,” many countries still rely mainly on cytology (Pap tests) rather than higher-performance HPV testing. Only six countries report using the HPV test as the primary screening test, with variable implementation and reach.

The shift matters because HPV testing can find risk earlier, and it supports a game-changing option for island contexts: self-sampling. PAHO has emphasized that HPV testing can allow women to collect a vaginal swab themselves, reducing barriers tied to time, privacy, discomfort, and clinic access. For Caribbean communities where transport, appointment availability, stigma, and workforce shortages collide, self-sampling can be more than convenience, it can be coverage.

3) Follow-up and treatment capacity are uneven, especially radiotherapy

Cervical cancer elimination is not achieved by screening alone. Women who screen positive need timely follow-up, treatment of pre-cancer, and if cancer is found, access to surgery, radiotherapy, and chemotherapy as clinically indicated.

PAHO warns that follow-up compliance is a major challenge across the Americas, and that treatment resources are uneven, with greater difficulties in English-speaking Caribbean countries where radiotherapy is not available in all countries. This is a key Caribbean reality: geography and small populations make it hard to justify, fund, staff, and maintain high-cost oncology infrastructure in every territory, so referral pathways and cross-border arrangements become life-or-death issues.

The human cost, and what it looks like in public health terms

CARPHA has highlighted how significant cervical cancer remains in the regional death profile. In a study CARPHA was involved with, cervical cancer accounted for 4.5% to 18.2% of cancer deaths in the English- and Dutch-speaking Caribbean, a wide range that suggests some countries are doing far better than others. CARPHA also notes that cancer is the second leading cause of death in the Caribbean region, underscoring why prevention and early detection are not optional add-ons, they are core health security issues.

What “elimination” actually means, and what Caribbean systems can do now

WHO’s elimination framework is built around 90–70–90 by 2030: 90% of girls fully vaccinated by age 15, 70% of women screened with a high-performance test by ages 35 and 45, and 90% of women with pre-cancer or invasive cancer appropriately treated. PAHO is clear that the Americas are not on track without major acceleration, because the current incidence in Latin America and the Caribbean remains far above the elimination threshold.

For Caribbean decision-makers, the most realistic near-term wins tend to cluster around five actions:

• Scale HPV vaccination with fewer missed opportunities, using school-based delivery where possible and simplified schedules where adopted.

• Move screening toward HPV testing, including self-sampling where appropriate, so programs reach women who do not attend routine clinics.

• Fix the “positive test to treatment” pipeline, with navigators, reminder systems, and clear referral timelines, because screening without follow-up does not save lives.

• Strengthen treatment access, including radiotherapy availability via national investment or formal regional referral routes where local provision is not feasible.

• Invest in cancer registration and monitoring, so planners can see who is being missed, where delays occur, and whether policy is translating into fewer late-stage diagnoses.

Cervical cancer is often described as preventable, and that is true, but prevention is a system, not a slogan. The Caribbean’s challenge is not discovering new science, it is delivering what already works, at scale, across islands and languages, with reliable follow-up and treatment. If January’s awareness campaigns lead to stronger vaccination uptake, more HPV testing, and fewer women lost between a positive screen and care, then awareness becomes impact.

PAHO’s Caribbean situational analysis explicitly notes that cervical cancer incidence data in the non-Latin Caribbean are “scarce,” and the report’s summary table lists St. Maarten as having incidence data, but it does not publish a St. Maarten case count or an incidence rate in the incidence table it presents.

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