This year, the focus for World Cancer Day is Close the Care Gap: Everyone deserves access to cancer care. Inequalities exist in many aspects of cancer, which can include the risk of developing it, overall survival, likelihood of effective and timely care, and access to palliative care. For example, countries with lower Human Development Index scores have been associated with higher rates of cancers that are associated with chronic infection and often patients die without any access to symptom relief despite its relative affordability. Furthermore, these countries often lack any type of cancer screening and if they do have it, it is poorly developed.
One particular cancer that highlights inequality in both prevention and treatment is cervical cancer. In a proactive tweet on January 4, 2022, in support of cervical cancer awareness month, the World Health Organization (WHO) stated that “Cervical cancer could be the first cancer EVER in the world to be eliminated”:
By the numbers:
Cervical cancer is the fourth most common cancer in women. 99% of these cases are linked to infection with human papillomaviruses (HPV). In 2020, 604,237 women were diagnosed with cervical cancer globally. Low to middle income countries, mainly in sub-Saharan Africa make up the most of these cases. Additionally, and further demonstrating the global inequalities of this disease, 90% of the cervical cancer deaths were in these less-developed regions, where access to prevention, screening, and treatment is severely lacking.
HPV Vaccine and Screenings:
Since it was introduced in 2006, 135 million doses of the HPV have been distributed in the United States. The vaccine has demonstrated strong efficacy with an 86% decrease in quadrivalent type HPV infections in female 14 to 19 and 71% decrease in women in their early 20s from 2006 to 2016. Studies have also shown a lasting effect and have found no evidence of the protection decreasing over time.
In addition to vaccines, screening using either a Pap test, an HPV test, or both, has led to around a 50% decrease in cervical cancer deaths. The 5-year survival rate for people with invasive cervical cancer that is caught early is 92%.
With these strong tools and addressing the global inequalities of treatment and screening, it is reasonable to believe there is a strong possibility of eliminating cervical cancer in the next century.
How to make this a reality:
In order to keep the world on the WHO’s goal to eliminate cervical cancer within the next century, each country is tasked with maintaining 3 key targets:
1. 90% of girls are to be fully vaccinated against HPV by the age of 15
2. 70% of women screened using high-performance test by the age of 35, and again by age of 45
3. 90% of women with pre-cancer will receive treatment and 90% of women with invasive cancer will have their condition properly managed
1. Sarfati D. Why social inequalities matter in the cancer continuum. In: Vaccarella S, Lortet-Tieulent J, Saracci R, et al., editors. Reducing social inequalities in cancer: evidence and priorities for research. Lyon (FR): International Agency for Research on Cancer; 2019. (IARC Scientific Publications, No. 168.) Chapter 3. Available from: https://www.ncbi.nlm.nih.gov/books/NBK566166/