Three years ago, I lost a close colleague, a fellow paediatrician, to cervical cancer. She was 43, vibrant, and seemingly healthy. By the time she developed symptoms, the disease was already advanced. Three months later, she was gone.
Her death was devastating not only because it was sudden, but because it was avoidable. Cervical cancer is one of the most preventable and treatable cancers. Yet, like many women, she had never been screened.
This is not an isolated experience in Egypt. Despite the availability of reliable prevention tools, cervical cancer remains largely absent from public conversation. Fewer than 10 percent of Egyptian women have ever been screened for cervical cancer, and among those diagnosed, more than half do not survive the disease. Screening is neither routinely offered nor widely accessible, meaning many women encounter the disease only after it has progressed.
Egypt has the tools to eliminate cervical cancer. What stands in the way is not science, but silence.
Persistent infection with the human papillomavirus causes the vast majority of cervical cancer cases. We know that vaccination, regular screening, and early treatment dramatically reduce both incidence and mortality. In countries where these measures are widely implemented, cervical cancer becomes rare.
But prevention does not succeed on evidence alone. Cervical cancer sits at the intersection of health, culture, and long standing beliefs about women’s bodies. Conversations around it can feel uncomfortable or unfamiliar, even among health professionals. Silence creates uncertainty, and uncertainty easily turns into fear.
In my work, I often encounter a persistent misconception that HPV, and therefore cervical cancer, is linked to sexual promiscuity. Some parents ask what vaccinating their daughters might imply. Others fear that even discussing HPV could be seen as encouraging inappropriate behaviour. Still others believe cervical cancer affects only certain types of women.
These perceptions are painful, but they matter. They reveal how easily a medical issue can be moralised, and how stigma can obstruct prevention. The reality is simple. HPV is one of the most common viruses worldwide. It affects people across societies and backgrounds. Vaccination does not change values or behaviour. It protects health. When disease is framed through shame rather than science, fear overwhelms facts.
When Rotary members in Egypt launched the United to End Cervical Cancer programme, a comprehensive initiative providing HPV vaccination for girls, screening for women, and sustained public awareness, we encountered a mixture of hesitation, concern, and at times outright resistance.
These reactions were challenging, but also instructive. They showed us that trust cannot be assumed. It must be built patiently, consistently, and respectfully.
We learned early on that awareness is not a single conversation. Behaviour change takes time, particularly when it touches on sensitive issues. What made a difference was returning to the same communities, working through trusted local figures, and listening as much as we spoke.
Gradually, we began to see a shift. Parents returned with follow up questions, sometimes bringing friends or relatives. Girls as young as twelve sought reliable information online. Sessions that began cautiously became more open, confident, and engaged.
This is slow work. But it is effective work.
Much of this progress has been possible because prevention efforts were embedded within existing community structures, including medical convoys, school programmes, and long standing health outreach initiatives. Rotary members, already active in preventive health and education, were able to integrate cervical cancer awareness into trusted community work. As trust grew, thousands of women came forward for screening, and nearly 16,000 girls have now received the HPV vaccine since the programme’s launch, with uptake continuing to rise.
This progress aligns with growing national efforts. Since 2020, cervical cancer has gained prominence within Egypt’s health priorities. In 2023, the Ministry of Health expanded early detection services to include cervical cancer within the Presidential Initiative for Early Detection of Cancer under the 100 Million Seha programme. This momentum was reinforced at a national conference on cervical cancer held in January 2026, where Egyptian and international experts advanced a unified roadmap toward elimination.
Yet, as our experience shows, access alone cannot overcome hesitation rooted in stigma, fear, and misinformation. Trust must grow alongside services.
Egypt has done this before. Hepatitis C was once widespread. Today, Egypt stands as a global example of what long term commitment can achieve. Breast cancer screening required years of coordinated effort before becoming routine. Cervical cancer prevention will require the same resolve, but the foundation has already been laid.
Knowledge is only the first step. Changing behaviour and culture demands patience, repetition, and humility, and a willingness to meet communities where they are, not where we wish them to be.
My message is simple. No woman should die from a cancer we know how to prevent. Cervical cancer elimination in Egypt is not a question of possibility, but of persistence.
With consistent effort across government institutions, health systems, civil society, and within families, we can ensure that future generations of women grow up protected by knowledge, access, and trust, rather than silence.
*Dr. Amal ElSisi is a Professor of Pediatrics at Cairo University, a Fellow of the Royal College of Physicians (London), a clinical leader in paediatric cardiac care, and director of Rotary’s United to End Cervical Cancer in Egypt programme. Her work spans clinical practice, interventional pediatric cardiology, medical education, and large-scale public health advocacy.
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