Minimum standards for radiation therapy in the treatment of cervical cancer in the U.S. A consensus statement by SGO, ASTRO, and ABS addressing the WHO Cervical Cancer Elimination Campaign goals

Cervical cancer remains a significant source of morbidity and mortality worldwide, both in high-income countries such as the United States and in low- and middle-income countries. Access to high quality radiation therapy (RT) is critical for improving outcomes yet remains a challenge even in high resource settings. The World Health Organization (WHO) announced the “Global strategy to accelerate the elimination of cervical cancer as a public health problem,” adopted by the World Health Assembly in 2020, which sets the laudatory goals of 90 % vaccination for HPV by the age of 15, 70 % screening rates by the ages of 35 and 45, and 90 % of those with cancer effectively treated by 2030. Access to high-quality RT for those with cancer is an integral part of this strategy, yet significant barriers remain to achieving this goal, including the geographic distribution of clinical technology, physician expertise, and socioeconomic disparities which often co-vary with the incidence of this disease. This article was developed by the Society of Gynecologic Oncology (SGO) taskforce on the elimination of cervical cancer in conjunction with the American Society of Radiation Oncology (ASTRO) and the American Brachytherapy Society (ABS), serving as a companion piece to the Minimum Quality Standards for Cervical Cancer in the United States position statement, and will identity the indications for radiotherapy, propose minimum and advanced standards for radiation quality, and discuss barriers and solutions to achieve comprehensive access.