Cervical cancer could be significantly reduced worldwide by the end of the century, researchers report in the journal "The Lancet Oncology". Two measures would be necessary for this: comprehensive vaccination programs against human papillomavirus (HPV) and preventive medical check-ups.
The international team of researchers used model calculations to analyze how the two measures would affect the global incidence of cervical cancer. The aim was to reduce the number of cases of cervical cancer from the current 14 per 100,000 people in the global average to four per 100,000.
In their simulation, scientists estimated that there are programs by 2020 that will vaccinate at least 80 percent of girls and young women against HPV and screen 70 percent of women aged 35 and 45. That could prevent around 13 million illnesses by 2069, the researchers calculate. For the calculations, the researchers use data from the International Agency for Research on Cancer (IARC) in Lyon.
Most common cause: HPV
Cervical cancer is the fourth most common cancer among women worldwide. In Germany, around 4600 women suffer from it each year. It is known that certain HPV types (especially HPV-16 and HPV-18) are responsible for around 90 percent of all cervical cancers. The most dangerous HP viruses have been vaccinated for more than ten years.
Without vaccination, almost every human being becomes infected with HPV once in a while, many of them at their first sexual contact. The infection goes unnoticed and mostly heals on its own. Only in a few cases can the immune system not eliminate the viruses. One possible consequence: cell changes that can develop up to cancer cells. Detected early enough, the tissue components can be removed with cell changes before a malignant tumor arises. Cervical cancer usually develops slowly. The health insurance companies in Germany so far pay women over 20 years once a year a so-called Pap smear.
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"Our findings indicate that global elimination is within reach - with resources that already exist," said Karen Canfell of the Cancer Council's New South Wales research facility in Sydney, lead author of the study.
So far the theory. In practice, however, the current vaccination rate in many countries is well below the required 80 percent: In Germany, only 31.3 percent of 15-year-old girls were fully vaccinated against HPV at the end of 2015, reports the Robert Koch Institute.
Who has paid? The study was funded by the National Health and Medical Research Council (NHMRC) Australia.
If vaccinations and preventive check-ups are not expanded, 44.4 million new cases would be expected in the next 50 years, the researchers warn. The number of newly formed tumors would more than double from 600,000 in 2020 to 1.3 million in 2069 due to the increasing world population and rising life expectancy.
When the goal of four cases per 100,000 inhabitants would be reached depends mainly on the degree of development of a country - the so-called index of human development, short HDI. In countries with a very high index, such as Germany or the US, this would be the case between 2055 and 2059. Low-HDI countries such as Ethiopia or Haiti could not reach the target until 2090 or 2100 or not at all.