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Womens Healthcare 2020

Cervical cancer elimination: A reality closer than we think

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Dr Matti Aapro

President European CanCer Organisation (ECCO)

Often associated with the human papillomavirus (HPV), cervical cancer is one of the biggest threats to women’s lives, but also one of the most easily preventable forms of cancers.

Cervical cancer: preventable and treatable

Deaths from cervical cancer are caused by a lack of access to health services for prevention, early detection, or adequate treatment. Cervical cancer screening is provided in most, but not all, European countries, but with a variable uptake. HPV testing, a more effective and accurate screening method, is only recently accepted in some countries.

In order to address these inequalities, a consensus resolution was passed during the European CanCer Organisation (ECCO) 2019 European Cancer Summit. This was the week after the WHO/EU Global Vaccination Summit, co-chaired by then EU Health Commissioner Vytenis Andriukaitis. The ECCO document urged that: “By 2030, effective strategies to eliminate cancers caused by HPV, as a public health problem, should be implemented in all European countries.”

In addition, ECCO has formed the ‘HPV Action Network’ composed of high-level cancer experts dedicated to achieving the elimination of all HPV caused cancers in Europe, including representatives of the European Society for Gynaecological Oncology (ESGO).

HPV is a very common sexually transmitted infection that up to 90% of sexually active women and men will encounter at some point in their lives. It is believed to cause about 5% of all cancers worldwide, and among those, almost all are cervical cancers.[1]

Cervical cancer prevention: HPV vaccination and HPV tests

The impact of HPV vaccination on cervical cancer incidence is undeniable. A large-scale study in Scotland found that, compared with unvaccinated women born in 1988, vaccinated women born in 1995 and 1996 had an almost 90% reduction in the highest-risk cervical pre-cancers.[2]

The HPV vaccine is most effective when administered in adolescence, before exposure to the virus through sexual activity. There is, however, value in vaccinating older male and female teenagers and young adults, at least up to the age of 26, because it can protect against a new infection or re-infection and block transmission to a new partner.[3]

HPV tests detect the presence of the HPV virus that is causing cervical cancer, and are being adopted by an increasing number of countries. Finland, Germany, Italy, the Netherlands, Sweden as well as the United Kingdom, Norway and Turkey outside of the EU, have either started to implement HPV screening on a regional or national level, or plan to do so. It has also been piloted in several other countries, including France, Poland and Portugal.

Now, more than ever,action is needed to improve the prevention of cervical cancer through HPV vaccination and universally accessible HPV testing across the European region. Together we can make HPV related cancer and cervical cancer elimination a reality.

[1] European CanCer Organisation (2019). Eliminating HPV-Caused Cancers & Diseases in Europe. |[2] Palmer T, Wallace L, Pollock KG, et al. Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study BMJ 2019; 365:l1161. doi: 10.1136/bmj.l1161. | [3] European CanCer Organisation (2019). Eliminating HPV-Caused Cancers & Diseases in Europe.

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