Cervical cancer could be all but eliminated in 80 years: Lancet study

Doug Hendrie

20/02/2019 1:52:37 PM

Cervical cancer could be eliminated by 2100 if the world rapidly moves to introduce HPV vaccines and screening, according to a new study.

HPV vaccines and HPV-based cervical screening could slash the death toll from cervical cancer.
HPV vaccines and HPV-based cervical screening could slash the death toll from cervical cancer.

The Lancet Oncology modelling study found 149 of 181 countries could cut rates of the preventable cancer to four per 100,000 women by the end of the century – the threshold for considering it eliminated as a public health problem.
The study finds that combining high uptake of the vaccine with high screening could prevent up to 13.4 million cases of cervical cancer within 50 years, with the most benefit in low and middle income countries.
‘[H]igh priority should be given to the effective implementation of high-coverage cervical screening and human papillomavirus [HPV] vaccination in low-income and middle-income countries,’ the study states.
More than 44 million women will be diagnosed with cervical cancer in the next 50 years if primary and secondary prevention programs are not implemented in low- and middle-income countries.
High-income countries could banish cervical cancer within a generation, with the study showing it could be eliminated as a public health problem within 25–40 years.
Lead author Professor Karen Canfell told newsGP the study is the first global picture of cervical cancer prevention.
‘This is a cancer that is completely preventable with these two lifesaving tools, HPV vaccination and screening, because it’s from a single cause. Cervical cancer is really the clearest preventable cancer,’ she said.
‘We’d like GPs to encourage parents of girls and boys at school to get vaccinated. Our coverage is now around 80% for girls and 76% for boys, so there’s still one in five who are not being vaccinated.’
The study comes after the World Health Organization (WHO) called last May for global action to eliminate the preventable cancer. The WHO is currently developing a global strategic plan.
VCS Foundation Executive Director, Associate Professor Marion Saville, said the new study was an important paper.
‘The paper maps out approaches needed to achieve a global elimination of cervical cancer, and some of the challenges in getting there,’ she told newsGP.
‘While it’s very encouraging, we can’t be complacent. There are challenges around resourcing.
‘Cervical cancer disproportionately affects low and middle income countries. There’s also the complicating factor of very high HIV rates in some countries, which means a woman [with HIV] who also gets HPV will be more likely to develop a cancer and do so more quickly.’
Associate Professor Saville said another issue is the bottleneck in HPV vaccine production.
In some countries, cervical screening has encountered cultural difficulties due to the need to collect cells from the cervix under older testing regimes.
‘Self-sampling is going to be critical to scaling up screening on a global scale, and having good management of health information on screening registers,’ Associate Professor Saville said. 

cancer cervical cancer HPV vaccine population health screening

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Elizabeth Hindmarsh   21/02/2019 9:49:54 AM

This is great news. We need to improve our HPV vaccination rates and keep testing for HPV.
Maybe the RACGP could assist some of our neighbors in Asia through our affiliations with their Colleges and GP Associations to deliver this care more widely to all the women in their countries.

Dr Peter J Strickland   21/02/2019 12:53:10 PM

Cervical cancer will only be eliminated in Australia if those likely to get the disease are BOTH vaccinated and screened at more frequent levels than being recommended at present. All the invasive cervical cancers I have diagnosed have all been in women with minimal symptoms of bleeding intermenstrual, but who had also been screened every 2 years, and one I remember was 18 years old and it was her first screen. The same applies to prostate cancer in men --- without frequent screening via DRE and PSA there will be increased deaths from high-grade tumours missed -- and we have to remember the deaths from prostate cancer are equivalent to breast cancer deaths in Australia. There is a wide program for breast cancer screening, but a minimal screening program for prostate cancer. In my opinion the "pink ribbon" monies collected should now be more widely utilised, and esp. for prostate cancer also, and renamed "pink/blue ribbon" --a much better gender balance, and higher monies collected.