New Delhi: High-income countries are on track to eliminate cervical cancer preventable through vaccination and screening by 2048, while low- and middle-income countries will see only slight declines over the next century, according to a study published in the journal The Lancet.
As a result, the gap between regions will widen dramatically, with women in low- and middle-income countries facing much higher rates of this preventable disease, researchers, including those from the Université Laval Research Center in Quebec in Canada, said.
Almost all cases of cervical cancer are associated with infection with high-risk human papillomavirus (HPV), a very common sexually transmitted virus, according to the World Health Organization.
She says cervical cancer is largely preventable through HPV vaccination and regular screening.
The UN health agency has set an elimination target of fewer than four cases per woman.
The World Health Organization says every country must achieve “90-70-90” targets by 2030, of 90 percent HPV vaccine coverage among 15-year-old girls, 70 percent of women aged 35 and 45 years screened, and 90 percent of women with pre-cancer and cancer treated to be on track to eliminate cervical cancer over the next century.
Reaching WHO targets for HPV elimination vaccination and screening or introducing universal vaccination with high coverage is essential to eliminating cervical cancer in low- and middle-income countries, which would significantly alleviate inequality around the world, the researchers said.
They said meeting the WHO 90-70-90 goals could prevent 37 million cases of cervical cancer over the next century and accelerate progress towards eliminating the disease.
However, models suggest that many low- and middle-income countries are unlikely to reach these targets without increased investment in disease eradication efforts, the team said.
The researchers designed five HPV prevention strategies in low- and middle-income countries, including a “status quo” scenario.
“As it stands, the model predicts that the incidence of cervical cancer in low- and middle-income countries will decline by only 23 percent while high-income countries will reach elimination by 2048, leading to significant increases in inequality,” the authors wrote.
“Achieving 90 percent vaccination coverage among girls in low- and middle-income countries would reduce these disparities and lead to their elimination in low- and middle-income countries outside sub-Saharan Africa,” they said.
Recent developments, such as low-cost, single-dose vaccines, have led to an expansion of screening programmes, the authors said.
They said that mass multi-age vaccinations and efforts to include boys in vaccination campaigns could help make eliminating cervical cancer possible worldwide.
However, the team said coordinated global efforts from governments and international health agencies are needed.
A September 2022 study published in Lancet Oncology predicted that single-dose vaccination with long-lasting protection and 90 per cent coverage could prevent up to 78 per cent of cervical cancer cases among vaccinated birth cohorts across India.
It is estimated that states with high rates of cervical cancer could see the largest relative decline in cases.
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