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According to research, cervical cancer could be effectively eliminated in most countries of the world by the end of the 21st century.
The human papillomavirus (HPV) vaccine, which protects against the virus responsible for most cases, has dramatically reduced the incidence of cervical cancer wherever absorption has occurred. been raised. It is hoped that the vaccine given to young girls, coupled with the occasional screening of HPV, will be able to put an end to the scourge of a disease that kills more than 300,000 women worldwide each year.
Last year, the Director General of the World Health Organization (WHO) called for coordinating global efforts to eliminate the disease. The research, published in the journal Lancet Oncology, shows how this could be achieved by increasing immunization coverage and screening.
If nothing happens, 600,000 women will develop cervical cancer in 2020, reaching 1.3 million per year by 2069 as the population grows and ages. But academics in Sydney, Australia, claim that 13.4 million cases of the disease could be prevented over the next 50 years by implementing high vaccination and screening coverage in all countries.
By the end of the century, the number of cases in the world would be reduced to less than four out of every 100,000 women – a level at which cancer could be considered effectively eliminated.
Diagram showing cases of cervical cancer and ways to prevent them in the next 50 years
With a slower adoption rate, countries with the highest levels of development would eliminate cancer by the end of the century, but countries with average levels would still have 4.4 per 100,000 and those with low levels would have 14 cases out of 100,000, says the study.
Professor Karen Canfell of the Cancer Council New South Wales, who led the study, said, "Our research team has already felt that Australia is on the way to eliminating cervical cancer. the uterus by 2035, with rates lower than four per 100,000 women per year by 2035. years, "she said. Very high income countries, such as England, Finland, the United States and Canada, would be able to eliminate it by 2055-2019.
"It is critical, however, to achieve elimination in all countries if we want to maintain – and hopefully improve – the participation rates in existing HPV vaccination programs and in HIV testing initiatives. cervix of the uterus. "
However, HPV vaccination programs have met with some opposition. The virus is sexually transmitted. In some communities, families chose not to participate in treatment, as their daughters' only sexual partner is their husband.
Elsewhere, the broadcast collapsed after the release of documentary films on young girls apparently ill after vaccination, suffering from fatigue and chronic pain. In Denmark and then Ireland, vaccination rates have decreased. A study by the European Medicines Agency concluded in 2015 that vaccines were not responsible for two specific syndromes in girls with symptoms that may overlap with chronic fatigue syndrome or chronic fatigue syndrome.
Campaigns to improve adoption had an effect in Europe, but not in Japan, which suspended the "proactive" recommendation of HPV vaccination in the face of public panic – known psychosomatic reactions – in June 2013. The Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine says rate of acceptance has increased from over 75% to less than 1%.
Heidi Larson, director of the Vaccine Confidence Project, said the adoption of the HPV vaccine remains a problem. There have been episodes of what appear to be psychosomatic events among girls' groups around the world, such as 600 girls from various schools in Colombia who were taken to the hospital faint, shaky and unconscious in 2014 .
The effects of such episodes are spreading around the world. Parents are looking for information about the vaccine that may be arriving in their area and are finding negative stories. "We thought everything would be fine in Armenia, but no one came," Larson said. "It's a challenge. It takes a lot of work and commitment. It is yet one of the best vaccines we have.
Canfell said the safety of the HPV vaccine has been regularly confirmed by the Global Advisory Committee on Vaccine Safety, which advises WHO. "In 2017, more than 270 million doses of HPV vaccines were administered," she said.
"Hostility and fear can delay the effective implementation of life-saving vaccines. We must be very clear about this: Millions of women can be spared unnecessary and terrible suffering if HPV vaccines can be effectively deployed and developed globally. "
The WHO's call for action is crucial, she said. "We must not forget that in some ways, the journey towards the elimination of cervical cancer has only just begun. For countries classified in the category of high human development – but not "very high" – and medium, such as China, Mexico, Brazil and India, the challenges are even greater because many of these countries do not have not yet major initiatives to support HPV vaccination and cervical screening.
"The challenge is even greater in the world's poorest countries, which not only have very limited access to these key innovations, but also some of the highest rates of cervical cancer in the world. For some countries in sub-Saharan Africa, cervical cancer is the leading cause of cancer death among women. It's a tragedy, not only for women, but also for their families and society in general. "
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