Could cervical cancer be eliminated in the USA within 2 decades?
The results of a novel modeling study suggest that increasing coverage of cervical cancer screening to 90% in the USA could prevent over 1,000 new cervical cancer cases each year and help eliminate the disease within 2 decades.
The results of a novel modeling study by researchers from the Harvard T. H. Chan School of Public Health (MA, USA) suggest that increasing coverage of cervical cancer screening to 90% in the USA will be more effective at accelerating national elimination of cervical cancer within 2 decades, compared with current cervical screening levels or increased HPV vaccination coverage.
Cervical cancer is one of the most preventable cancer forms, due to effective cervical screening procedures for early disease detection and HPV vaccination. In 2018, the WHO called for global eradication of cervical cancer, setting a prevalence target of the disease of fewer than four cases per 100,000 individuals.
Currently, it is recommended that both boys and girls aged 11–12 years receive HPV vaccination. Cervical screening is recommended for women over the age of 21 years, every 3 years; however, an estimated 14% of women never undergo screening.
This study represents the first attempt to assess the potential for cervical cancer elimination in the USA and whether this could be expedited by adopting increasing screening or vaccination coverage, as well as put a timeframe on this.
Utilizing current vaccination and screening trends, researchers employed two distinct cervical cancer microsimulation models to predict and compare the ‘status quo’ impacts of nine different vaccination or screening interventions on the national eradication of cervical cancer.
Researchers observed that under status quo conditions, cervical cancer could be eliminated in the USA by 2038–2046; increasing cervical cancer screening coverage to 90% could accelerate national disease elimination by up to 13 years.
By contrast, investigators determined that scaling up HPV vaccination coverage to 90% of girls – or vaccinating both men and women aged 26–45 years – resulted in minimal changes to the rate of disease elimination.
Co-lead study author Emily Burger (Harvard T. H. Chan School of Public Health) explained: “Although HPV vaccination will be a major contributor to reducing cervical cancer over time, we found that in the immediate term, screening continues to play a critical role in reducing the burden of cervical cancer in [USA].”
“Together with the WHO elimination initiative, we hope this analysis will galvanize public health efforts to improve access to both primary and secondary cervical cancer prevention in the [USA],” stated senior study author Jane Kim (Harvard T. H. Chan School of Public Health).
In the study, the authors concluded: “Targeting of under-screened and under-vaccinated women remains key to achieving cervical cancer elimination for all women.”
Burger EA, Smith MA, Killen J et al. Projected time to elimination of cervical cancer in the USA: . The Lancet Public Health. doi:10.1016/S2468-2667(20)30006-2 (2020) (Epub ahead of print);