Cervical cancer could be eliminated in most countries by 2100 if the world increases its vaccine coverage and medical screenings, according to new research.
The research, published in Lancet Oncology this week, outlines the ways in which scaled-up human papilloma virus (HPV) vaccination and cervical screenings could lead to global elimination of the cancer in 181 countries between 2020 and 2099.
Cervical cancer currently kills more than 300,000 women every year, according to the World Health Organization (WHO).
The HPV vaccine, Gardasil, was first approved in 2006. It protects against a virus that leads to most cervical cancer cases. It has already greatly decreased the number of cancer cases in areas where the vaccine has been well received, and this week’s research shows that the impact could be even more dramatic with increased uptake.
The study suggests that 600,000 women will develop cervical cancer in 2020 if no action is taken, a number that would increase to 1.3 million by 2069, according to the Guardian.
“Widespread coverage of both HPV vaccination and cervical screening from 2020 onwards has the potential to avert up to 12.5 – 13.4 million cervical cancer cases by 2069, and could achieve average cervical cancer incidence of around four per 100,000 women per year or less,” the report summary reads.
This reduced number of cancer cases essentially means the disease would be eliminated by the end of the century in most countries.
“Our research team has previously estimated that Australia is on track to eliminate cervical cancer by 2035, with rates dropping below four per 100,000 women annually within the next 20 years,” Professor Karen Canfell from the Cancer Council New South Wales, who headed up the Lancet study, told the Guardian. “Crucially, though, achieving elimination in all countries will depend on sustaining — and hopefully improving — rates of participation in existing HPV vaccination programs and cervical screening initiatives.”
High-income countries like England, the US and Canada would follow by 2055-59.
But, as stated, vaccination efforts are key, and they have been met with some criticism over the years.
Some families have decided against vaccinating their daughters, saying that their husbands will be their only sexual partners, the Guardian reported in 2012.
Others became afraid of the vaccine and questioned its safety after it appeared to cause negative reactions in some. In Denmark and Ireland, specifically, vaccine rates dropped after a documentary about girls becoming sick with chronic fatigue and pains from the vaccine was released, according to the Guardian.
In 2015, a review by the European Medicines Agency determined that the vaccine did not cause two syndromes some thought to be related to it: complex regional pain syndrome (CRPS) and postural orthostatic tachycardia syndrome (POTS). There was no evidence that “the overall occurrence of these syndromes in vaccinated girls were different from expected occurrence in these age groups.”
Around the world, programs have been launched to encourage the vaccinations, but they haven’t worked everywhere. There were instances of psychosomatic reactions to the vaccine in Japan, which spread fear and led people to question its safety. Vaccination rates in Japan went from over 70% to under 1% due to scare campaigns.
There were psychosomatic reactions in Colombia in 2014, too.
Widespread coverage of #HPV vaccination & cervical screening has the potential to eliminate #cervicalcancer in most countries by the end of the century - new modelling study in @TheLancetOncolhttps://t.co/wpoPKGYz6vpic.twitter.com/JfaTigqENp— The Lancet (@TheLancet) February 20, 2019
“It is challenging. It takes a lot of work and a lot of engagement. Yet it is one of the best vaccines we have,” Heidi Larson, director of the Vaccine Confidence Project, told the Guardian.
The safety of the vaccine has been confirmed by the Global Advisory Committee on Vaccine Safety, which works with the WHO, according to Canfell.
She also pointed out that there is an even greater challenge in developing countries that not only lack resources but that also experience high cervical cancer rates.
“For some countries in sub-Saharan Africa, cervical cancer is the leading cause of cancer death in women. This is a tragedy, not only for women, but also for their families and broader society,” Canfell said.
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, called for united efforts on elimination cervical cancer in 2018 and Larson says this call to action is vital.
“Hostility and fear has potential to delay the effective implementation of lifesaving vaccines. We must be very clear about this: millions of women can be spared unnecessary, terrible suffering if HPV vaccines can be effectively deployed and scaled up globally,” Canfell said.