Eliminating the global threat of cervical cancer
Our researchers have investigated the potential for cervical cancer to be eliminated as a public health problem by the end of the century in most countries globally.
Background
Globally, one woman dies of cervical cancer every two minutes and it remains one of the gravest threats to women’s lives. Cervical cancer is the fourth most common cancer in women worldwide and the leading cause of cancer death in some of the world’s poorest countries, for example those in sub-Saharan Africa, with 85% of cervical cancers occurring in less-developed regions. Notably, HPV is responsible for virtually all cases of cervical cancer.
Cervical cancer is one of the most preventable and treatable forms of cancer. Well-established cervical screening programs have already had a dramatic impact on cervical cancer incidence in high-income countries.
Previous Cancer Council NSW research has shown that Australia is on track to be the first country in the world to eliminate cervical cancer as a health problem, due to the success of the HPV vaccination program and the 2017 changes to the National Cervical Screening Program. If vaccination and screening coverage are maintained at their current rates, this target is set to be reached by 2035 in Australian women.
The research
This study has a global focus and follows on from the 2018 call-to-action by the World Health Organization for action towards the elimination of cervical cancer as a public health issue, recognising the enormous potential to reduce and prevent suffering from cervical cancer worldwide.
This study found that achieving widespread global coverage of both human papillomavirus (HPV) vaccination and cervical screening, from 2020 onwards, could potentially prevent up to 13.4 million cases by 2070 and has the potential to achieve world-wide elimination of cervical cancer in most countries by 2100.
The research provides the first estimates of the potential timeline to cervical cancer elimination by quantifying the impact of two key steps: the rapid dispatch and administration of HPV vaccinations to 80-100% of the world’s population of young girls and effective delivery of twice-per-lifetime HPV-based screening in all less-developed countries, with a 70% coverage rate. If high coverage vaccination and screening can be scaled up together, this will avert a cumulative 12.5-13.4 million cervical cancer cases over the next fifty years and will see average cervical cancer rates decline below what could be considered as elimination thresholds, less than 4 cases per 100,000 people, by the end of the century.
The impact
The study shows that it is feasible to achieve global elimination of cervical cancer as a public health problem if global health organisations act now. If both HPV vaccination and HPV-based screening are scaled up rapidly enough, up to 13.4 million cervical cancer cases could be prevented by 2069.
Though implementation efforts towards the global elimination of cervical cancer are only in the early stages, this research demonstrates the potential to achieve world-wide elimination of cervical cancer in most countries by 2100.
The study reinforces that a high priority should be given to the effective implementation of high coverage cervical screening, as well as HPV vaccination, in low and middle-income countries. It also highlights the importance of continued participation in the National Cervical Screening Program and national HPV immunisation program in Australia.
Research team
Cancer Council NSW
Dr Kate Simms
Dr Julia Steinberg
Dr Michael Caruana
Dr Megan Smith
Dr Jie-Bin Lew
Professor Karen Canfell (pictured)
External Collaborators
Dr Isabelle Soerjomataram
Dr Philip Castle
Dr Freddie Bray