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 the end of this century, researchers said yesterday.
Without screening and HPV vaccination, more than 44 million women will likely be diagnosed with the disease over the next 50 years, the researchers 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, the report said.
By contrast, the rapid deployment starting next year of screening and vaccination could prevent more than 13 million cervical cancers by mid-century worldwide and lower the number of cases to less than 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 WHO reported 570,000 new cases worldwide last year, 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 Sydney-based Cancer Council New South Wales.
However, achieving that goal 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 percent of cervical cancer cases.
The study’s projections presumed that the vaccination of 80 percent of girls aged 12 to 15 starting next year and that at least 70 percent of women undergo screening twice in their lifetime.
This would push the prevalence of the disease to less than the bar of four per 100,000 women in countries such as the US, Canada, Britain and France by 2059, and in mid-income countries such as Brazil and China by 2069, the authors said.
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