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

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