Impact of scaled up human papillomavirus vaccination and cervical screening and the potential for global elimination of cervical cancer in 181 countries, 2020–99: a modelling study
Abstract
Background Cervical screening and human papillomavirus (HPV) vaccination have been implemented in most high-income countries; however, coverage is low in low-income and middle-income countries (LMICs). In 2018, the Director-General of WHO announced a call to action for the elimination of cervical cancer as a public health problem. WHO has called for global action to scale-up vaccination, screening, and treatment of precancer, early detection and prompt treatment of early invasive cancers, and palliative care. An elimination threshold in terms of cervical cancer incidence has not yet been defined, but an absolute rate of cervical cancer incidence could be chosen for such a threshold. In this study, we aimed to quantify the potential cumulative effect of scaled up global vaccination and screening coverage on the number of cervical cancer cases averted over the 50 years from 2020 to 2069, and to predict outcomes beyond 2070 to identify the earliest years by which cervical cancer rates could drop below two absolute levels that could be considered as possible elimination thresholds-the rare cancer threshold (six new cases per 100 000 women per year, which has been observed in only a few countries), and a lower threshold of four new cases per 100 000 women per year. Methods In this statistical trends analysis and modelling study, we did a statistical analysis of existing trends in cervical cancer worldwide using high-quality cancer registry data included in the Cancer Incidence in…
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Cervical cancer elimination can be achieved in every country with the proposed threshold of four or fewer cases per 100 000 women-years.
“as well as on our modelling results (and those of Simms and colleagues34) showing that cervical cancer elimination can be achieved in every country with this threshold.”
Cites
Lew, J.-B., Simms, K. T., Smith, M. A., Hall, M., Kang, Y.-J., Xu, X. M., Caruana, M., Velentzis, L. S., Bessell, T., Saville, M., et al. (2017) · The Lancet Public Health · doi:10.1016/s2468-2667(17)30007-5 · Cited by 160 · see citing works
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Planning for tomorrow: global cancer incidence and the role of prevention 2020–2070
Soerjomataram, I., & Bray, F. (2021) · Nature Reviews Clinical Oncology · doi:10.1038/s41571-021-00514-z · Cited by 1,012 · see citing works
Self-citationBrisson, M., Kim, J. J., Canfell, K., Drolet, M., Gingras, G., Burger, E. A., Martin, D., Simms, K. T., Bénard, É., Boily, M.-C., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30068-4 · Cited by 943 · see citing works
Self-citationCurrent status of human papillomavirus vaccination in India's cervical cancer prevention efforts
Sankaranarayanan, R., Basu, P., Kaur, P., Bhaskar, R., Singh, G. B., Denzongpa, P., Grover, R. K., Sebastian, P., Saikia, T., Oswal, K., et al. (2019) · The Lancet Oncology · doi:10.1016/s1470-2045(19)30531-5 · Cited by 136 · see citing works
Whitworth, H. S., Gallagher, K. E., Howard, N., Mounier-Jack, S., Mbwanji, G., Kreimer, A. R., Basu, P., Kelly, H., Drolet, M., Brisson, M., et al. (2020) · Vaccine · doi:10.1016/j.vaccine.2019.12.017 · Cited by 118 · see citing works
Global elimination of cervical cancer as a public health problem
Brisson, M., & Drolet, M. (2019) · The Lancet Oncology · doi:10.1016/s1470-2045(19)30072-5 · Cited by 118 · see citing works
Simms, K. T., Keane, A., Nguyen, D. T. N., Caruana, M., Hall, M. T., Lui, G., Gauvreau, C., Demke, O., Arbyn, M., Basu, P., et al. (2023) · Nature Medicine · doi:10.1038/s41591-023-02600-4 · Cited by 105 · see citing works
Self-citationBonjour, M., Charvat, H., Franco, E. L., Piñeros, M., Clifford, G. M., Bray, F., & Baussano, I. (2021) · The Lancet Public Health · doi:10.1016/s2468-2667(21)00046-3 · Cited by 73 · see citing works
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- Authors
- Simms, K. T., Steinberg, J., Caruana, M., Smith, M. A., Lew, J.-B., Soerjomataram, I., Castle, P. E., Bray, F., & Canfell, K.
- Affiliations
- Cancer Council NSW (AU)
- Centre international de recherche sur le cancer (FR)
- Albert Einstein College of Medicine (US)
- The University of Sydney (AU)
- Corresponding author
- Canfell, Karen
- ORCID
- Venue
- The Lancet Oncology
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 20
- Issue
- 3
- Pages
- 394-407
- ISSN
- 1470-2045 (ISSN-L)
- OpenAlex
- W2915174157
- Cited by
- 486
- References
- 1
- Citations by year
- 2026: 52 · 2025: 70 · 2024: 68 · 2023: 64 · 2022: 64 · 2021: 64 · 2020: 73 · 2019: 29
- FWCI
- 43.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Oncology (publishedVersion)
- PubMed (publishedVersion)
- The Sydney eScholarship Repository (The University of Sydney) (submittedVersion)
- Funders
- National Health and Medical Research Council (APP1007994, NCT02328872, ACTRN12613001207707)
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- cervical cancer elimination, HPV vaccination, cervical cancer screening, HPV vaccine, cervical cancer incidence, case averted, low- and middle-income countries, Human Development Index, cancer incidence projections, cervical cancer burden, global health equity, cancer registry, Cancer Incidence in Five Continents
- MeSH terms
- Adolescent, Adult, Uterine Cervical Neoplasms, Cervix Uteri, Female, Humans, Middle Aged, Vaccination, World Health Organization, Papillomaviridae, Papillomavirus Infections, Papillomavirus Vaccines, Early Detection of Cancer, Young Adult
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