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Upscaling rollout of HPV vaccine could 'eliminate' cervical cancer in some countries, study finds

The disease claims the lives of more than 300,000 women every year.

Image: Shutterstock/Jarun Ontakrai

THE RAPID SCALE-UP of the human papillomavirus (HPV) vaccine could virtually eliminate cervical cancer in a handful of rich countries within three decades, and in most other nations by century’s end, according to researchers. 

Without screening and HPV vaccination, more than 44 million women will likely be diagnosed with the disease over the next 50 years, they reported in The Lancet Oncology, a medical journal.

Two-thirds of these cases – and an estimated 15 million deaths – would occur in low- and medium-income countries.

By contrast, the rapid deployment starting in 2020 of screening and vaccination could prevent more than 13 million cervical cancers by mid-century worldwide, and lower the number of cases to below four-per-100,000 women, the study found.

“This is a potential threshold for considering cervical cancer to be eliminated as a major public health problem,” the authors said in a statement.

Earlier this month, the World Health Organization (WHO) reported 570,000 new cases worldwide in 2018, making it the fourth most common cancer for women after breast, colon and lung cancer.

The disease claims the lives of more than 300,000 women every year, mostly in lower-income nations.

“Despite the enormity of the problem, our findings suggest that global elimination is within reach,” said lead author Karen Canfell, a professor at the Cancer Council New South Wales, in Sydney.

Achieving that goal, however, depends on “both high coverage of HPV vaccination and cervical screening,” she added.

Transmitted sexually, HPV is extremely common and includes more than 100 types of virus, at least 14 of them cancer-causing. 

The viruses have also been linked to cancers of the anus, vulva, vagina and penis.

It takes 15 to 20 years for cervical cancer to develop in women with normal immune systems. If the immune system is weak or compromised – by HIV infection, for example - the cancer can develop far more quickly.

Clinical trials have shown that HPV vaccines are safe and effective against the two HPV strains – types 16 and 18 – responsible for 70% of cervical cancer cases.

The study’s projections presume the vaccination of 80% of girls 12 to 15 years old starting in 2020, and that at least 70% of women undergo screening twice in their lifetime.

This would push the prevalence of the disease below the bar of 4/100,000 women in countries such as the United States, Canada, Britain and France by 2059, and in mid-income countries such as Brazil and China by 2069, the authors calculate.

HPV in Ireland

Health Minister Simon Harris has asked the HSE to introduce HPV testing as a primary screening method for the prevention of cervical cancer “as soon as possible”, it was reported last week

An Oireachtas Committee last week heard that the rollout of the new cervical cancer test in Ireland has been held up by the backlog in smear tests.

The health committee was also told last week that there are 78,000 slides left in the CervicalCheck smear backlog.

Fianna Fáil health spokesman Stephen Donnelly asked when HPV testing, which is more accurate than current smear exams, will be introduced.

Harris promised it would be introduced in September last year. This was then pushed out to January 2019. 

HSE officials said that no start date has been committed to for the new HPV test, and it would take at least nine months to sign a contract with the service provider who will undertake and review the tests. 

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Taoiseach Leo Varadkar was asked about why the promise was being rolled back on. He said the government is “absolutely still committed” to the new test.

What’s the difference between a smear test and the HPV test?

The smear test detects abnormal cells that may develop into cancer if left untreated.

HPV testing is used to look for the presence of HPV in cervical cells. These tests can detect HPV infections that cause cell abnormalities, sometimes even before cell abnormalities are evident.

Like the smear test, the HPV test is done on a sample of cells collected from the cervix.

© AFP 2019 with reporting by Christina Finn

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