Cervical cancer is the “cancer we can eliminate”, said the World Health Organisation (WHO) as it urged its member states to consign the disease to history.
According to Cancer Research UK there are around 3200 new cases of cervical cancer diagnosed in the UK each year, with the disease responsible for 853 UK deaths each year. Cervical cancer incidence rates have decreased by a quarter (25%) in the UK since the early 1990s, and over the last decade, cervical cancer incidence rates have remained stable in the UK, the charity highlighted.
The WHO pointed out that”cervical cancer is a difficult disease with traumatising effects”. It commented that 5-year survival rates range from 54% to 80% depending on the country – in the UK Cancer Research UK stated that 6 in 10 women survive their disease for 5 years or more.
“As a gynaecologist who has treated women with cervical cancer, I have witnessed the fear people experience of a cancer growing in one’s body,” said Dr Nino Berdzuli, director of country health programmes at WHO/Europe. “Cervical cancer is preventable,” she said, “no woman should die from it”.
Elimination of Cervical Cancer Roadmap
At its annual regional committee meeting in Tel Aviv tomorrow, WHO/Europe plans to ask its 53 member states, from across Europe and Central Asia, to endorse a roadmap to accelerate the elimination of cervical cancer as a public health problem in the region.
The Roadmap to accelerate the elimination of cervical cancer as a public health problem in the WHO European Region 2022-2030 outlines core principles, strategic shifts and priority actions to guide member states in reaching the 2030 targets – the “90-70-90 targets” – set by the global strategy for cervical cancer elimination:
- 90% of girls fully vaccinated with the HPV vaccine by age 15
- 70% of women screened using a high-performance test by age 35, and again by age 45
- 90% of women identified with cervical disease receive treatment – 90% of women with pre-cancer treated, and 90% of women with invasive cancer managed
Achieving these targets requires strong political commitment from member states, the WHO said, as well as an appropriate investment in care pathways, workforce training, communications, and monitoring.
HPV Vaccination Crucial
Countries need to reach 90% national vaccination coverage by 2030 to be on track to meet the elimination goal the WHO said. “The most effective way to reach this target is to include HPV vaccination in national immunisation programmes and invest in effective communication strategies,” it explained.
The UK has had a national HPV vaccination programme since 2008. In the 2020 to 2021 academic year coverage for the first HPV vaccine dose was 76.7% for year 8 females and 81.8% for year 9 females. For the second dose coverage was 60.6% for year 9 females.
A study published last year in the Lancet estimated that the human papillomavirus vaccine has reduced the incidence of cervical cancer by 87% in women in their 20s in England who were offered the vaccine when they were aged 12-13 years as part of the UK HPV vaccination programme.
The authors of the study said that the HPV immunisation programme had “almost eliminated cervical cancer in women born since Sept 1, 1995”.
At the time, Michelle Mitchell, chief executive of the charity Cancer Research UK, hailed the results as a “historic moment” that demonstrated the power of science.
Screening Uptake Needs to be Better
The WHO said that the second valuable tool for cervical cancer elimination is a national organised screening programme, which ensures that all the necessary services are provided – from early detection and diagnosis, through to treatment and follow-up care. Effective cervical cancer screening is not just a test or a single event, “it is a pathway”, it said.
In the UK, recent Government figures showed that uptake of cervical screening is around 40% for women aged 24.5 to 49 years, who are invited for screening every 3 years. For those women aged 50 to 64 years old, who are invited for screening every 5 years, uptake is around 48%.
“HPV vaccination and national screening programmes combined with strong awareness and community engagement campaigns, proper health workforce capacity training, and innovation to produce local solutions to local challenges are our means to cervical cancer elimination,” said Dr Berdzuli.
She highlighted that HPV vaccination and cervical cancer screening have been designated as ‘best-buy interventions’ with immediate returns on investment. “They significantly reduce avoidable illness and death as well as the need for expensive treatments which have serious health side effects,” she explained.
Eliminating Cervical Cancer
“Countries that have achieved real success include the United Kingdom, one of the early adopters,” said the WHO, which pointed out: “The route to addressing HPV may vary based on country contexts and resources, but the destination is the same – eliminating cervical cancer.”
By striving to achieve the ambitious 90-70-90 global targets by 2030, all countries in the region are setting themselves on a pathway to “eliminating cervical cancer as a public health problem”, said the WHO.
Dr Berdzuli said that a cervical cancer free future is “within our grasp” and highlighted the momentous opportunity for political and health leaders to achieve cervical cancer elimination. “We have the knowledge and tools, but we need stronger and more consistent commitments to make elimination possible across our region,” she explained. “Through equitable delivery of the HPV vaccine, national organised screening programmes and quality treatment, we can prevent and treat cervical cancer.”