Sydney, 31 January 2020 - The World Health Organisation (WHO) is developing a plan to eliminate cervical cancer globally, and two new studies published today in Lancet estimate the potential benefits. The studies, led by Cancer Council NSW, Université Laval and Harvard University working with the World Health Organisation, have found that over 74 million cervical cancer cases and 62 million deaths could be averted over the next 100 years if 78 of the poorest countries in the world are able to rapidly scale up HPV vaccination, cervical screening and access to cancer treatment services. This follows last year's Cancer Council NSW paper, which found that global elimination of cervical cancer is possible by the end of the century.
The two studies focus on 78 low and lower-middle income countries (LMIC) which bear the largest cervical cancer burden, located in East Asia & Pacific, Europe & Central Asia, Latin American & Caribbean, Middle East & North Africa, South Asia, and Sub-Saharan Africa. In these countries, combining vaccination of girls with twice-lifetime cervical screening and improved access to invasive cervical cancer treatment was predicted to reduce cervical cancer incidence by 97% and mortality by almost 99%, and avert over 74 million cervical cancer cases and over 62 million deaths in the next 100 years.
These figures rely on three targets being met in these countries by 2030: 90% of girls being vaccinated against HPV, 70% coverage for twice-lifetime cervical screening with HPV testing, and 90% coverage for treatment of preinvasive lesions and invasive cancer.
Adjunct Professor Karen Canfell, Director of Research at Cancer Council NSW and Adjunct Professor at the University of Sydney, who co-led both studies, said, "These results will inform the global strategy to achieve cervical cancer elimination, which is being reviewed by WHO's Executive Board next week and which will be considered by countries at the World Health Assembly in May 2020."
"Cervical cancer causes over 300,000 deaths worldwide each year, yet the evidence shows it could be eliminated as a public health issue."
"Australia has been at the forefront - through being the first country in the world to establish an HPV vaccination program and the shift two years ago to a new National Cervical Screening Program based on HPV testing. It is a great example of the government and nongovernment sectors working together and has positioned Australia to take a leading role globally.
"Our goal is a cancer-free future and this study shows that it can be done, for a cancer that causes hundreds of thousands of deaths each year throughout the world."
Previously, Cancer Council NSW researchers have found that Australia is set to be the first country to eliminate cervical cancer, by as early as 2035, through successful implementation of a combined approach to vaccination and screening. However, this is not the case elsewhere around the globe. Cervical cancer is still the fourth most common cancer in women worldwide and the leading cause of cancer death in 42 countries, including some of the world's poorest countries, for example those in sub-Saharan Africa. In 2018, the large majority of the 570,000 new cervical cancer cases worldwide occurred in women living in LMICs.
"While Australia has one of the world's lowest cervical cancer rates, we still have a long way to go to achieve our elimination goal - globally and in Australia," Professor Canfell said.
"Given that over 90% of cervical cancer deaths occur in less-developed regions, these countries must be our first priority for implementation of HPV vaccination programs, high coverage cervical screening, and establishing cancer treatment services. This will help alleviate the enormous global inequities with the burden of this devastating disease.
"In Australia, we can build on our successes and further reduce cervical cancer deaths by at least 20%, by supporting the renewed screening program and reaching priority populations - particularly Aboriginal and Torres Strait Islander women and others who screen at low rates and face cultural and economic barriers to services.
"Everyone can get behind our push for a cervical cancer free future, from individuals who can engage in the screening and immunisation programs and health professionals checking their patients are up to date with screening and vaccination, to policy makers and collaborators who can drive this agenda globally."
Both papers can be viewed in full here:
- Mortality impact of achieving WHO cervical cancer elimination targets: a comparative modelling analysis in 78 low-income and lower-middle-income countries
- Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries
