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Elimination of cervical cancer in sight

This story was originally published on the Royal Women’s Hospital website.

Cervical cancer could be effectively eliminated within the next 40 years, with Australia set to be the first country, according to the world’s leading cervical cancer experts.

In a statement published in the journal Papillomavirus Research on International HPV Awareness Day, the International Papillomavirus Society (IPVS) has for the first time outlined that cervical cancer could soon be eliminated as a public health problem.

The IPVS is made up of the world’s leading cervical cancer and Human Papillomavirus (HPV) researchers, including Professor Suzanne Garland from the Royal Women’s Hospital and University of Melbourne, and advises the WHO and global policymakers on cervical cancer prevention and screening.

It comes as new research is published showing a dramatic decline in the rates of HPV, the infection that causes about 99.9 percent of cervical cancer, the majority of anal cancer, and a proportion of vulvar, vaginal, penile, tonsillar and back of tongue cancers.*

Professor Garland who is the Director of the Centre for Women’s Infectious Diseases at the Royal Women’s Hospital said Australia would likely be the first country to effectively eliminate the disease; however, ongoing screening and high uptake of the vaccine were key to that being achieved.

“We are forecasting that over the next 30-40 years, rates of cervical cancer will drop from around the current 930 cases a year in Australia to just a few,” she said.

“Our national HPV immunisation program for both boys and girls, combined with our cervical cancer population screening, means we are well positioned to be the first country to effectively end this deadly cancer.”

The latest research from Professor Garland’s team, published in the Journal of Infectious Diseases, is showing that rates of HPV in women has dramatically dropped due to the effectiveness of the vaccination program.

Researchers found that amongst women aged 18 to 24, the HPV rate had dropped from 22.7 percent to just 1.1 percent over the last 10 years. While only 53 percent of women were vaccinated, the ‘herd effect’ had helped deliver a better than anticipated decline. Recent research has also shown a decline in HPV amongst males.

Prior to the vaccination program, almost all sexually active people had contracted HPV.

“If we continue with a successful vaccination program for boys and girls and our population screening for HPV, then we can effectively eradicate this cancer. The research is showing a decline in rates of the cancer-causing HPV; however due to the delay between contracting HPV and cervical cancer developing, we expect it to be a few more years before we see a steep decline in rates of cervical cancer,” Professor Garland said.

The majority of cervical cancers globally happen in the developing world where there are no population screening programs. Around 430,000 women each year are diagnosed with cervical cancer. The cost-effective vaccine is slowly being rolled out in many countries.

The IPVS has highlighted that eliminating the disease globally depends on high uptake of the vaccine in countries across the world, developing and developed.

“The effectiveness of the vaccine and a lower cost is likely to make it possible for us to eliminate the disease in low socioeconomic countries too,” Professor Garland said.

Professor Garland said high rates of screening was crucial to achieving elimination as between 10 and 30 percent of HPV that causes cervical cancer is not covered by the vaccine.

Background:

Very low prevalence of vaccine human papillomavirus (HPV) types among 18 to 35-year-old Australian women, nine years following implementation of vaccination, was published in the Journal of Infectious Diseases, February 2018. The study was led by the Royal Women’s Hospital, University of Melbourne and the Murdoch Children’s Research Institute.

*HPV is linked to 99.9 percent of cervical cancer, 90 percent of anal cancers, 65 percent of vaginal cancers, 50 percent of vulva cancers, 35 percent of penile cancers and 60 percent of oropharyngeal cancers (cancers of the back of the throat, including the base of the tongue and tonsils).

See the International Papillomavirus Society’ statement here.

Thanks to generous donations from our supporters, ACRF contributed to the initial seed-funding of Professor Ian Frazer’s research into the cervical cancer (HPV) vaccine in 1999.