Cervical cancer is the fourth most common type of cancer in women worldwide. This specific type of cancer is also preventable and curable if caught early. Cervical cancer is caused by the human papillomavirus (HPV). Case studies from different parts of the world have shown that the HPV vaccine leads to a significant reduction in cervical cancer cases, as well as other types of cancers linked to HPV, such as anal, oral, vulvar, vaginal, and penile cancers.
The Director-General of the World Health Organization (WHO) has started a global initiative to eliminate cervical cancer. Elimination of cervical cancer is a step on the path to eradication, which is achievable if the goals are met related to increasing vaccination and screening rates, in addition to increased access to effective treatment strategies.
Many large studies have demonstrated that the HPV vaccine is both a safe and efficacious method of primary prevention of cervical cancer. The available HPV vaccines target the types of HPV that most often lead to cervical cancers, such types 16 and 18. Unfortunately, the vaccine rates remain very low in many parts of the world.
There are several barriers to HPV vaccination. First, misinformation related to the safety and purpose of HPV vaccine is common. Targeted educational programs are a method to address misinformation. Access to vaccine is reduced in both rural and impoverished areas of the world, necessitating outreach programs. Finally, there are cultural and societal barriers to vaccine which requires community engagement and the help of influential community leaders to overcome.
Using case studies of decreased cervical cancer rates related to increased HPV vaccine rates in both India and Sweden, it is understood that that elimination of cervical cancer is possible if specific goals are met. These countries have both demonstrated that high rates of HPV vaccination can lead to 85% reductions in HPV 16 and 18 in women. Additionally, reductions in HPV infections have significantly decreased in males in these countries due to herd effect.
The WHO Director-General has established the goal of elimination of cervical cancer globally. This goal can be met if there is a global HPV vaccination rate of 90% among girls prior to the age of 15. The additional components of this strategy include increased screening and treatment. The target for screening is that 70% of women are tested by the age of 35, and again by the age of 45. The treatment targets include 90% of women with pre-cancer are treated and 90% of women with invasive cancer are managed.
The elimination of cervical cancer is a challenging goal but it is not impossible. There are countries well on their way to elimination of cervical cancer by increasing vaccine rates, in combination with improved screening and treatment of cervical cancers. These goals can be met with the help of schools, healthcare facilities, and outreach strategies.
References
1. Rathod S, Potdar J, Gupta A, et al. Empowering Women’s Health: Insights Into HPV Vaccination and the Prevention of Invasive Cervical Cancer. Cureus. 2023 Nov; 15(11): e49523. doi:10.7759/cureus.49523
2. Jit M, Prem K, Benoard E, Brisson M. From Cervical Cancer Elimination to Eradication of Vaccine-Type Human Papillomavirus: Feasibility, Public Health Strategies and Cost-Effectiveness. Prev Med. 2021 Mar; 144: 106354. doi: 10.1016/j.ypmed.2020.106354
3. Cervical Cancer Elimination Initiative. Accessed May 22, 2024. https://www.who.int/initiatives/cervical-cancer-elimination-initiative Assessed and Endorsed by the MedReport Medical Review Board