World Cancer Day: action for protection against cervical cancer

Cervical cancer is among the most common types of cancer affecting women in the WHO European Region, with 69 000 new cases and 30 000 deaths estimated for 2018 alone. Yet unlike most other types of cancer, it is vaccine-preventable.

On World Cancer Day, WHO/Europe aims to raise awareness that timely vaccination against human papillomavirus (HPV) in combination with regular screening for cervical cancer is the best way to protect girls’ futures from this tragic disease.

Success in controlling cervical cancer requires action by individuals, health-care professionals and policy-makers at national and global levels to ensure that everyone has easy access to the facts, the vaccines and the screening they need.

Building on a good start

Countries of the Region are making steady progress in protecting girls and women from the most common HPV strains, which are responsible for up to 90% of cervical cancer cases worldwide.

Starting with several countries that were among the first to introduce HPV vaccination globally, 37 of the 53 European Member States now include HPV vaccination of girls aged 9–14 in their routine immunization schedules. Some also offer the vaccine to boys to help reduce transmission of the HPV strains in the vaccine.

Unfortunately, uptake of the vaccine varies. Some countries have reached over 90% coverage of the target group, while others face challenges that have limited uptake to 20%. About 80% of those who are not vaccinated will be infected with 1 or more types of the virus at some time in their lives. Girls who miss the opportunity to prevent HPV-related cancers through vaccination will be vulnerable to contracting and passing on this virus when they become sexually active.

Individual action: vaccine advocates

Being well informed and drawing appropriate health-related information from credible, evidence-based sources empowers individuals to make decisions that can save their own and others’ lives.

Laura Brennan was diagnosed with terminal cervical cancer in 2017. Realizing that the HPV vaccine could have protected her if she had received it, she decided to dedicate her life to health advocacy to empower girls and their parents to choose vaccination against HPV.

By actively encouraging parents to get the facts and by spreading the message that “the HPV vaccine is the best tool we have to prevent this cancer from happening”, Laura has greatly contributed to the efforts of the Irish Health Service Executive (HSE) to reassure parents about the benefits of the vaccine.

The work of Laura and advocates like her around the world is helping to ensure that those who have the opportunity to vaccinate embrace it to protect their future and that of their children.

National success: Portugal

Portugal was among the first countries in the world to introduce HPV vaccination after the first HPV vaccine was licensed globally in 2006. In November 2018, the national vaccination programme celebrated 10 years of success in sustaining about 90% coverage among the designated target groups (birth cohorts of girls 1992–2006).

At the celebration, Dr Ana Leça from the Technical Commission on Vaccination explained that Portugal owes its success to “support from the scientific community, health-care workers and the media; a strategic communication campaign; and a well functioning national immunization programme”.

Global goal: cervical cancer elimination

WHO recognizes cervical cancer as a public health problem. In May 2018, the WHO Director-General announced a global call to action towards its elimination.

The Director-General highlighted the role of appropriate, good-quality, safe and innovative technologies and strategies to reach all girls with HPV vaccination and to reach women with cervical cancer screening, early diagnostics and effective treatment services for both precancerous lesions and invasive cancers, including palliative care – all embedded within universal health coverage strategies. Additional political commitment globally will be decisive in making this a reality.

WHO/Europe works closely with countries in the Region to prepare for the introduction of the HPV vaccine, improve access to vaccines at an affordable price, assess progress, and address the spread of misinformation about the vaccine and the diseases it causes.

The virus and the vaccine

Virtually all cervical cancer cases are linked to genital infection with HPV. HPV is also linked to other types of anogenital cancer, head and neck cancers, and genital warts in both men and women. Most HPV infections are transmitted through sexual contact.

Three different vaccines are available to prevent infection, all of which have been proven both safe and highly effective in reducing rates of precancerous cervical growths. Of the 3 vaccines, 2 also protect against genital warts.