Scaling up the human papillomavirus (HPV) vaccine could eradicate cervical cancer in high-income countries within 30 years, with most other countries following by the end of the century, according to new research.
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In 2018, there were 570,000 new cases of cervical cancer, which represented 6.6% of all female cancers. The World Health Organization (WHO) stated that around 90% of these deaths occurred in low- and middle-income countries.
Human papillomavirus (HPV) belongs to a family of viruses that affect the skin and membranes lining the body, including the cervix, anus, and the mouth and throat.
HPV is extremely common, and there are more than 100 strains, 14 of which are oncogenic (cancer-causing). These strains have been linked to cervical cancer in women, as well as anal, penis, and some types of head and neck cancer in men as well.
It is believed that the high mortality rate from cervical cancer could be dramatically reduced through prevention, early diagnosis, and effective screening and treatment programs.
Lead author of the study and a professor at the Cancer Council New South Wales in Sydney Karen Canfell said that reaching a point of virtual elimination in all countries will “depend on sustaining – and hopefully improving – rates of participation in existing HPV vaccination programs and cervical screening initiatives.”
There are vaccines currently available that protect against two strains of HPV: strains 16 and 18. These strains are responsible for 70% of cervical cancer cases.
Without further intervention through vaccination, over 44.4 million women will be diagnosed with cervical cancer across the next 50 years, according to a study published on The Lancet Oncology.
While the vaccine has been rolled out in most high-income countries, middle- and low-income countries do not enjoy the same level of coverage. The World Health Organization has called for global action to scale up vaccination, screening, treatment of pre-cancer, early detection and quick treatment of early invasive cancers, as well as palliative care.
However, The Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine revealed that acceptance rates dropped from over 75% to under 1%.
There has been a backlash against the HPV vaccine after reports of a number of girls in Colombia began presenting adverse psychosomatic symptoms including fainting and unconsciousness after receiving the vaccine.
Epidemiological investigations by Colombian health authorities found no “organic association” between the HPV vaccine and their adverse symptoms.
With a scale-up of global vaccination coverage to 80 to 100% with a broad-spectrum HPV vaccine by 2020 “6.7-7.7 million cases” could be prevented, the Australia-based study claimed, but added “more than half of these cases will be averted after 2060.”
For low- and middle-income countries, the study posited that undertaking screenings twice per lifetime at the ages of 35 and 45 years with 70% global coverage would “avert a total of 12.5-13.4 million cases in the next 50 years.”
Canfell has said that “despite the enormity of the problem, our findings suggest that global elimination is within reach.”
But, the study also warns that rates of less than four new cases per 100,000 women wouldn’t be achieved by the end of the century in every country with a low human development index.
We should not forget that in some senses the journey towards cervical cancer elimination is only just the beginning... The challenge is even greater in the world’s poorest countries, which not only have had very limited access to these key innovations, but also have some of the highest rates of cervical cancer in the world.”
Karen Canfell, Senior Author
She emphasized the situation as a “tragedy, not only for women but also for their families and broader society.”
In 2020, the World Health Assembly will consider a draft global strategy that aims to “accelerate cervical cancer elimination”, and findings brought about by this new study have helped to develop elimination targets for the period 2020-30.