HPV Vaccination – Accelerating the Global Elimination of Cervical Cancer

This post originally appeared on Medium on Sept. 20, 2018.

Sally Cowal, ACS

Sally Cowal, ACS

by Amb. Sally Cowal, Sr. Vice President, Global Cancer Control, American Cancer Society

What if I told you we had the tools to eliminate one type of cancer around globe, and yet, were not being using them to their full potential? Cervical cancer elimination is feasible through joint implementation of two high impact “Best Buy” interventions — screening for early detection and treatment and Human Papillomavirus (HPV) vaccination of adolescents, which prevents the infection that causes cervical cancer (and 5 other cancers).[1]

While long term routine screening programs and increasing rates of HPV vaccination in high income countries, such as the United States, has led to a steady decline of cervical cancers, many low and middle-income countries have poor screening and HPV vaccination coverage. In 2018 alone, 570,000 cases were diagnosed, and 311,000 women died from cervical cancer globally — 90% of these occurred low and middle-income countries. [2] And this dire situation may worsen, as deaths from cervical cancer are projected to increase almost 50% by 2030.[3] This is an astounding example of a global disparities in cancer outcomes. Where you live should not determine if you live.

If you are a woman diagnosed with cervical cancer in the United States, you would likely seek immediate medical advice, receive a plan of treatment, and begin treatment for the disease if available. All this would happen with the support of family, friends and local caregivers. But take this same diagnosis for a woman in Kenya or Uganda, and the outcome looks vastly different. Cervical cancer often has few symptoms until it has reached its advanced stages. With low awareness of cancer and a lack of routine screening, women are often diagnosed in the late stages, with no access to immediate treatment, no second opinions, very little pain relief, and little community support or understanding about the disease. These women are often diagnosed in the prime of their lives, and seeking treatment often means deciding between their own life and the livelihood of their families.

Now is the time for us to act. The global community has the tools to eliminate cervical cancer. Governments around the world should move to implement national cervical cancer screening programs with broad and consistent coverage and HPV vaccination campaigns, especially in adolescent girls, using appropriate platforms for high coverage. Bottlenecks and poor integration of services and sectors should be addressed. Civil society and the cancer community can act by advocating for these programs and increasing awareness and demand by sharing appropriate, consistent, and accurate messaging around screening and vaccination. These messages should combat stigma and fear by communicating to the public that the cervical cancer screening and HPV vaccination are cancer prevention and are safe and effective. Community influencers such as teachers, religious leaders, etc. should be mobilized to support these efforts and spread these messages.

Because HPV vaccination prevents the infection which causes cervical cancer, and other HPV associated cancers, it is especially key to stemming the burgeoning tide of cervical cancers in future generations. We need to continue to work with in-country partners to integrate HPV vaccination into existing health systems, promote awareness and understanding, and create demand for the vaccine when these communities are most vulnerable. If we prevent cervical cancer before it starts, we can drastically reduce disparities and save the lives of hundreds of thousands of women all over the globe.

[1] http://www.who.int/ncds/management/WHO_Appendix_BestBuys.pdf

[2] https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/global-cancer-facts-and-figures/global-burden-of-cancer-in-women.pdf

[3] http://www.who.int/reproductivehealth/DG_Call-to-Action.pdf