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Cervical cancer could be eliminated in Australia in the next two decades thanks to a government program to vaccinate children against the human papilloma virus, which causes cancer, according to a new report.
The study, published this week in The Lancet Public Health, found that by 2028, fewer than four out of every 100,000 women could be diagnosed with cervical cancer each year in Australia – effectively eliminating the disease as a public health problem. And by 2066, according to researchers, less than one woman a year could receive this diagnosis.
"Australia is fast becoming the first country to eradicate cervical cancer," said Karen Canfell, cancer epidemiologist and director of cancer research at the NSW Cancer Council. Organization that led the study. "I think this shows the way forward for other countries."
Australia's national health care system introduced the vaccination program in 2007 as a free three-dose course for adolescent girls. In 2013, the program was extended to boys of school age, who can carry and transmit the virus and develop other forms of cancer. According to the Cancer Council Australia, vaccination resulted in a 77% reduction in HPV types most responsible for cervical cancer. Australia now has one of the lowest incidence and death rates of cervical cancer in the world.
The researchers attributed the rapid decline of HPV to a combination of effective government action – which has seen the vaccination program implemented in schools across the country – associated with screening programs for older women and widespread public support .
Canfell stated that while immunization has played a crucial role, cervical cancer screening has also been instrumental in reducing HPV levels in older people who have previously been exposed to the carcinogenic virus. "If we only focus on immunization," she said, "we would not be able to solve this problem for hundreds of millions of women."
Other countries have progressed more slowly, in part because of a global anti-vaccination movement that falsely claimed that vaccines were linked to autism and disease.
While most developed countries have now implemented some form of vaccination program, the road has been heavy, said Ian Frazer, co-creator of the vaccine, Gardasil, and professor of immunology at the University of Queensland. He attributed these problems to the difficulties encountered in implementing a national immunization program and widespread misinformation about vaccine risks.
In Japan, for example, the fear campaigns helped to reduce the HPV vaccination rate from 70% to almost zero. In the United States, where a survey conducted in 2017 found that nearly half of people aged 18 to 59 are infected with genital HPV, the rate of vaccinated adolescents is only 49% .
During the 2014/15 school year in Ireland, 87% of girls aged 12 to 13 were vaccinated, but this figure dropped to 50% the following year, before rising to 62% in 2017. The Irish Cancer Society warned that, according to statistics, at least 40 more women would die due to the drop from 87 to 62% – a decrease caused at least in part by the spread of misinformation about the vaccine on social media. Boys in Ireland are not part of the vaccination program, although the The government is committed include boys next year.
"It takes a lot of education to get there, it does not happen overnight," Frazer said. He added that even vaccinating a half-population could, however, be enough to stop the spread of HPV and lead to a significant decrease in cancer rates.
But, he added, inequities in public health could mean that these declines are concentrated only in certain parts of the population.
Globally, cervical cancer remains the fourth most common type of cancer in women, and an additional 570,000 are expected this year alone. The burden of disease is concentrated in low- and middle-income countries, many of which have not yet adopted their own HPV vaccination programs. According to Canfell, screening is doubly important in these countries.
But even in Australia, the researchers said that continued screening and vaccination would be critical to maintaining low cancer incidence rates and mortality. "We are delighted with this news, however, we do not want women to become complacent," said Leisa Ashton, spokesperson for the Australian Cervical Cancer Foundation.
Australians should feel lucky, Ashton added, that their government has recognized the merits of vaccination.
– New York Times
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