• 1 Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA
  • 2 Harvard School of Public Health, Boston, MA
  • 3 Department of Anaesthesiology, Aga Khan University Medical College, Karachi, Pakistan
  • 4 Department of Obstetrics and Gynecology, University of Botswana, Gaborone, Botswana
  • 5 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
  • 6 Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA
  • 7 Worldwide Hospice Palliative Care Alliance, Fairfax, VA
  • 8 Gynecologic Oncology Unit and Palliative Care Service, Clínica Las Condes, Santiago, Chile
  • 9 Normah Medical Specialist Center, Sarawak, Malaysia
  • 10 Cancer Institute of Cheikh Anta Diop University, Dakar, Senegal
  • 11 Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
  • 12 Radiation and Isotope Centre, Oncology Hospital, Khartoum, Sudan
  • 13 Division of Gynecologic Oncology, Massachusetts General Hospital, Boston, MA
  • 14 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
  • 15 Department of Gynecology and Obstetrics, Johannes Gutenberg University Medical Center, Mainz, Germany
  • 16 Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
  • 17 Department of Medicine, Harvard Medical School, Boston, MA
  • 18 Institute of Palliative Medicine, Medical College, Kerala, India
  • 19 College of Public Health Science, Chulalongkorn University, Bangkok, Thailand
  • 20 Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • 21 Department of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
  • 22 Hope Institute Hospital, Kingston, Jamaica
  • 23 National Cancer Institute, Bethesda, MD
  • 24 Department of Non-communicable Diseases, World Health Organization, Geneva, Switzerland
JCO Glob Oncol, 2021 06;7:873-885.
PMID: 34115527 DOI: 10.1200/GO.21.00026


Women with cervical cancer, especially those with advanced disease, appear to experience suffering that is more prevalent, complex, and severe than that caused by other cancers and serious illnesses, and approximately 85% live in low- and middle-income countries where palliative care is rarely accessible. To respond to the highly prevalent and extreme suffering in this vulnerable population, we convened a group of experienced experts in all aspects of care for women with cervical cancer, and from countries of all income levels, to create an essential package of palliative care for cervical cancer (EPPCCC). The EPPCCC consists of a set of interventions, medicines, simple equipment, social supports, and human resources, and is designed to be safe and effective for preventing and relieving all types of suffering associated with cervical cancer. It includes only inexpensive and readily available medicines and equipment, and its use requires only basic training. Thus, the EPPCCC can and should be made accessible everywhere, including for the rural poor. We provide guidance for integrating the EPPCCC into gynecologic and oncologic care at all levels of health care systems, and into primary care, in countries of all income levels.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.