WHO target against cervical cancer still a long way off: Lancet study

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The study used the International Center for Research on CancerIARC’s Global Cancer Observatory (GLOBOCAN) 2020 database to estimate the burden of cervical cancer incidence and mortality rates in 185 countries. In 2020, the overall incidence was 13 per 100,000 women; mortality was 7 per 100,000 women. As many as 172 of 185 countries have seen more than the elimination threshold of 4 cases per 100,000 women per year set by the World Health Organization (WHO).

The development of effective vaccination against the human papillomavirus (HPV), which causes cervical cancer, and screening programs have made cervical cancer a largely preventable disease. In 2020, the WHO announced a goal to accelerate the elimination of the disease as a public health problem, aiming to reduce the incidence to less than 4 cases per 1,00,000 women per year in each country of by 2030. This study tracks progress in cancer rates and identifies countries and regions where scaling up efforts are needed to meet WHO targets.

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Dr Deependra Singh, cancer epidemiologist at IARC/WHO, France, said The Indian Express: “The effectiveness of vaccination in reducing the incidence of cervical cancer takes several years or decades. Screening and treatment of precancerous and invasive cervical cancer remains fundamental to achieving the WHO elimination goal. Vaccination should be encouraged as well as sexual health education in schools; it should be part of the school curriculum.

Dr Singh said the study detected encouraging decreases in some high-income countries such as Sweden, Australia and the UK following the successful implementation of HPV vaccination and screening programs, but globally, the burden remains high. “All over the world, women should be safe from the risk of preventable cancer, and with the development of effective vaccines and screening over the past 20 years, we have the tools to make this a reality,” said he declared.

Cervical cancer case rates ranged from two cases in Iraq to 84 in Eswatini per 100,000 women per year, while death rates ranged from one death in Switzerland to 56 deaths in Eswatini per 1 00,000 women per year.

An analysis of data from 1988 to 2017 shows a clear socioeconomic gradient in incidence and mortality, with higher rates seen in countries with lower socioeconomic development.

The study found a significant drop in cases in Latin American countries, including Brazil, Colombia and Costa Rica; Asian countries like India, Thailand and South Korea; and Poland, Slovenia and the Czech Republic in Eastern Europe.

However, the number of cases has increased over the past decade in Latvia, Lithuania and Bulgaria, parts of East Africa, as well as the Netherlands and Italy. Reasons for the recent increases could include an increased prevalence of HPV among younger generations of women and a lack of effective screening programs, according to the study report.

The countries with the largest average declines in incidence rates per year are Brazil (8%), Slovenia (7%), Kuwait (7%) and Chile (6%). The highest rate increases were observed in Latvia (4%), Japan (3%), Ireland (3%), Sweden (3%), Norway (2%), Northern Ireland (2 %), in Estonia (2%). , and China (2%).

The report’s estimates are based on the best available data on cancer in each country, although the authors caution that these may be incomplete or inaccurate. For example, cases may appear low in countries where there are no effective screening programs, or where limited data from local population-based cancer registries are available.