HPV Vaccinations Could Eliminate Cervical Cancer

Cervical cancer could be eliminated by the end of this century with the rapid expansion of existing vaccinations and screening interventions, according to a modeling study published in The Lancet Oncology journal. 

This study’s estimates, which are the first of their kind at a global-scale, indicate that combining high-uptake of the human papillomavirus (HPV) vaccine and HPV-based cervical screening rates from 2020 onwards could prevent up to 13.4 million cases of cervical cancer globally within 50 years. 

Moreover, the average rate of annual cervical cancer (CC) cases across all countries could fall to less than 4 cases per 100,000 women by the end of the century. 

Without expanding current CC prevention programs, however, this study predicts that 44.4 million CC cases would be diagnosed over the next 50 years--rising from 600,000 in 2020 to 1.3 million in 2069. 

"Despite the enormity of the problem, our (study’s) findings suggest that global elimination is within reach with tools that are already available, provided that both high coverages of HPV vaccination and cervical screening can be achieved", says Professor Karen Canfell from the Cancer Council New South Wales, Sydney, Australia who led the study. 

"More than two-thirds of CC cases prevented would be in countries with low and medium levels of human development like India, Nigeria, and Malawi, where there has so far been limited access to HPV vaccination or cervical screening,” said Canfell in a press release. 

According to the World Health Organization (WHO), cervical cancer is the 4th most common cancer in women, with an estimated 570,000 new cases diagnosed worldwide in 2018. And, HPV is a group of more than 150 viruses which is responsible for the majority of cervical cancers. 

Proven methods are available to screen for and treat cervical pre-cancers, and broad-spectrum HPV vaccines can potentially prevent up to 84-90 percent of CCs, says the WHO. 

Recently, in a statement issued on February 4, 2019, the International Agency for Research on Cancer fully endorsed the position of the World Health Organization (WHO) on human papillomavirus (HPV) vaccination. 

The WHO has confirmed that the HPV vaccination is safe, efficacious, and critical in the fight against cervical cancer. 

And separately, a study published on January 28th, 2019, reported a large number of women who never received an HPV vaccination are benefiting from “herd immunity.” 

Herd-Immunity protection is when everyone benefits from having a large portion of the population vaccinated against a particular disease. 

This 10-year study conducted by researchers from the University of Cincinnati and published in the journal Pediatrics found 32 percent of the non-vaccinated women tested positive for the HPV strains at the beginning of the study. 

But, 10 years later, the rate of HPV infection had decreased to just 19.4 percent in the study participants. 

"This data shows that the HPV vaccine is living up to its promise," said Dr. Amanda Dempsey, an associate professor of pediatrics at the University of Colorado, who wrote an accompanying editorial published in Pediatrics. 

"The overarching message is, this HPV vaccine works great in the 'real world,” said Dr. Dempsey. 

These Lancet study authors analyzed registry data from the International Agency for Research on Cancer to predict future trends in cervical cancer if further action is not taken.

They then used a dynamic model to calculate the impact of scaling up HPV vaccination and cervical screening on the CC burden globally, and in 181 countries of all levels of development, between 2020 and the end of the century. 

The authors note several limitations, including that their predictions are constrained by a lack of high-quality cancer incidence data over time, particularly in developing countries. 

The Lancet study was funded by the National Health and Medical Research Council (NHMRC) Australia. It was conducted by researchers from Cancer Council New South Wales, Sydney, NSW, Australia; the Albert Einstein College of Medicine, Bronx, NY, USA; the International Agency for Research on Cancer, Lyon, France.