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Working towards a world free of cervical cancer


Paul Hayes


5/03/2018 3:50:22 PM

Modern healthcare tools mean the world can be rid of cervical cancer in coming decades, but it will require a united effort from governments and international stakeholders, public health physician Associate Professor Julia Brotherton told newsGP.

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Australian HPV rates in women aged up to 24 have fallen from 24% to 1% over the last decade.

‘If we do not act the global burden of cervical cancer will increase over the coming decades; whereas if we work together we can reverse this trend and indeed work towards a world free of cervical cancer,’ Associate Professor Brotherton told newsGP.
 
‘I don’t think this will be easy, but the first step is saying it is now possible with the technology and experience we have.’
 
Associate Professor Brotherton’s comments follow the International Papillomavirus Society’s (IPVS) statement, ‘Moving towards elimination of cervical cancer as a public health problem’. Released to coincide with International HPV [human papillomavirus] Awareness Day on 4 March, the IPVS statement calls on ‘health authorities to adhere to international standards developed by WHO [World Health Organization] to develop national, regional and local plans to ultimately achieve the goal of cervical cancer elimination as a public health problem’.
 
New Australian research has revealed a major decline in vaccine-targeted HPV rates in women aged up to 24, with infection with types 6, 11, 16 and 18 plummeting from 24% to just 1% over the last decade. The decline follows Australia’s implementation of a national HPV immunisation program with the quadrivalent HPV vaccine for females in 2007, with boys vaccinated from 2013. Australia is now using the nonavalent HPV vaccine, which has extended protection to a further five cancer-causing types (31, 33, 45, 52 and 58).
 
Associate Professor Brotherton, who is a member of the IPVS’s policy committee, believes continued developments in the healthcare methods used to combat cervical cancer – primarily broad-spectrum HPV vaccines and more effective screening strategies – are key to the goal of eventual elimination.
 
‘We know broad-spectrum HPV vaccines could remove oncogenic types from circulating in a population if we can sustain coverage of over 80% in males and females,’ she said.
 
HPV-based screenings are essential for the millions of women already exposed and infected with HPV who missed out on the protection of the vaccine. HPV-based testing is needed less frequently and has advantages that can make it far more feasible in resource-poor settings. It is more sensitive [than previously standard cytology-based Pap testing], and can be rapidly turned around and automated.
 
Associate Professor Brotherton feels that given the availability of such effective tools, the next step in eliminating cervical cancer around the world is an increased level of international ‘political will and commitment’.
 
‘The WHO will be convening an expert meeting later this year to examine the issues involved in considering an elimination goal for cervical cancer,’ she said. ‘With a global commitment to this goal and sharing of expertise, we hope to see the tools needed made accessible to all countries.’



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