Science

UK could be free from the burden of cervical cancer by 2055, experts predict

Boosting prevention could see the effective elimination of the disease in high income countries well before the century's end, say scientists.

Cervical cancer could effectively be eliminated from the UK in around three decades, saving thousands of lives, experts claim.

Scientists made the prediction after plotting the long-term effects of high levels of smear test screening and vaccination.

The study showed that in high income countries such as the UK, US, Finland and Canada, cervical cancer could cease to be a public health problem in as little as 35 years.

There was also a chance of the disease being eliminated globally by the end of the century if enough women were screened for papillomavirus (HPV) and vaccinated.

Without an expansion of prevention programmes, however, the world could see numbers of cases soar in the next 50 years due to population growth and ageing, the researchers warned.

Cervical cancer is chiefly caused by the HPV virus, which is transmitted by sex and intimate skin-to-skin contact.

Each year there are 3,126 new cases of cervical cancer in the UK and 854 women die from the disease.

But in high income countries the disease is on the retreat thanks to HPV vaccination and screening.

Today an estimated 99.8% of cases in the UK are considered to be preventable.

In May last year the World Health Organisation called for co-ordinated action to eliminate cervical cancer.

Professor Karen Canfell, from the Cancer Council New South Wales in Sydney, Australia, who led the new study published in The Lancet Oncology journal, said: “Despite the enormity of the problem, our findings suggest that global elimination is within reach with tools that are already available, provided that both high coverage of HPV vaccination and cervical screening can be achieved.”

Currently a big gap exists between richer and poorer countries when it comes to cervical cancer prevention.

In 2008 average screening rates were 63% in high income regions but as low as 19% in low and middle-income countries.

The study showed that boosting global vaccination coverage to 80%-100% by 2020 and twice lifetime screening rates to 70% could result in cervical cancer being eliminated in the richest countries by 2055-59.

At that point fewer than four in 100,000 women per year would be developing the disease.

Poorer countries would take longer to eliminate cervical cancer under this scenario, in some cases having to wait until beyond the end of the century.

However African countries were not expected to banish the disease by 2100 even with high levels of vaccination and twice lifetime cervical screening.

Currently an estimated 570,000 new cases of cervical cancer are diagnosed each year worldwide, making it the fourth most common cancer in women.

Around 85% of these cases occur in less developed regions.

Rapid scale-up of HPV vaccination and screening could prevent up to 13 million cases of cervical cancer around the world by 2050, said the study authors.

Without enhanced prevention, the researchers predicted that 44.4 million women globally would be diagnosed with cervical cancer in the next 50 years, rising from 600,000 in 2020 to 1.3 million in 2069.

Commenting on the findings, Mark Jit, professor of vaccine epidemiology at the London School of Hygiene & Tropical Medicine, said: “We now have the technological tools, an effective vaccine and a highly sensitive screening test, to eliminate both cervical cancer and the virus that causes it. 

“However, uptake of these life-saving interventions has been poor in low and middle-income countries, despite the majority of cervical cancer deaths occurring in these countries.

“Making a significant dent in these deaths will require concerted global effort, and include engaging with populations and bringing vaccines and screening programmes into communities that have never seen them before.”

To carry out the study the scientists analysed high quality data from the International Agency for Research on Cancer to predict future trends under a “business-as-usual” scenario.

They then carried out a computer simulation to calculate the impact of scaling up HPV vaccination and  screening in 181 countries between 2020 and the end of the century.

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