Cervical cancer rates remain high globally despite efficacy of HPV vaccine

Cervical cancer rates in 2020 were 13 per 100,000 women, which is significantly higher than the World Health Organization’s (WHO) target of four per 100,000 women, according to a study published in The Lancet Global Health journal.

The WHO say that despite cervical cancer rates decreasing in many areas of the world over the past three decades, the burden remains high in many low and middle-income countries, due to a lack of access to the HPV vaccine.

Cervical cancer rates varied significantly between countries

The HPV vaccine has been found to reduce cervical cancer rates by almost 90%, meaning that the disease is largely preventable.

In light of this, the WHO set a target to reduce incidence below a threshold of four cases per 100,000 women per year in every country by 2030.

To track the progress on cervical cancer rates, the WHO use IARC’s GLOBOCAN 2020 database to estimate the prevalence of cervical cancer across 185 countries.

Data from 2020 reveals that rates of cervical cancer cases were 13 per 100,000 women per year and there were seven deaths per 100,000 women per year. The data reveals that only 13 countries are meeting the WHO’s target of four cases per 100,000 women per year.

Rates varied significantly between countries, with a 40 times difference in cases and 50 times difference in deaths. Case rates ranged from two cases in Iraq to 84 cases in Eswatini per 100,000 women per year; while mortality rates ranged from one death in Switzerland to 56 deaths in Eswatini per 100,000 women per year.

There was substantial socioeconomic inequality in cervical cancer globally. There was a clear socioeconomic gradient in incidence and mortality, with higher rates observed in countries with lower socioeconomic development.

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

Cases may appear low in countries where there are no effective screening programmes

Dr Deependra Singh, International Agency for Research on Cancer (IARC) / WHO, France, says “HPV vaccination and screening technologies mean that cervical cancer is now largely preventable.

“Our study finds encouraging decreases in some high-income countries following successful implementation of HPV vaccination programmes and screening—such as in Sweden, Australia, and the UK—but globally the burden remains high.

“All over the world, women should be free from the risk of preventable cancer, and with development of effective vaccines and screening over the past 20 years, we have the tools to make this a reality.”

However, Dr Valentina Lorenzoni, Scuola Superiore Sant’Anna, Italy, said the study’s results indicate that there is “still much work to be done before 2030”.

The authors note that while the estimates are based on the best available cancer data in each country, the data may be incomplete or inaccurate. For example, cases may appear low in countries where there are no effective screening programmes or there is limited local population-based cancer registry data available.