OP-ED: Eliminating cervical cancer to save 30,000 lives every year in Latin America and the Caribbean

Dr Jarbas Barbosa

Editor’s Note:  The views, thoughts, and opinions expressed in the article belong solely to the author, and not necessarily to DNO, its employees, or any affiliate company.

Strategies to expand HPV vaccination, combined with innovative screening and early treatment have made cervical cancer the first cancer in the world that can realistically be eliminated. From 5th to 7th March 2024, the Pan American Health Organization (PAHO) will convene with governments, donors, and civil society in Cartagena, Colombia, for the Global cervical cancer elimination forum, an opportunity for the Americas to, once again, take the lead in accelerating progress towards disease elimination.

Cervical cancer, caused by persistent infection with high-risk strains of human papillomavirus (HPV), is a leading cause of cancer-related death of women in Latin America and the Caribbean, with over 63,000 diagnosed each year and 33,000 lives lost. It is also a disease that disproportionately affects impoverished women in situations of vulnerability, with the vast majority of deaths occurring in low and middle-income countries.

The path to elimination is ambitious but simple: Countries must vaccinate 90% of girls by the age of 15; screen 70% of women for HPV by 35 years, and again by 45; and treat 90% of women with pre-cancer and cancer.

When it comes to vaccination, the Americas is ahead of other World Health Organization (WHO) regions, with 48 of 51 countries and territories already incorporating the HPV vaccine into their national schedules. Yet progress has been uneven, with some countries achieving high levels of coverage while others lag behind.

While the COVID-19 pandemic has played a role in this, the high cost of HPV vaccines, as well as a lack of access to vaccine services, particularly in remote areas, and insufficient vaccinations at school, have all hampered HPV vaccination coverage in the region.

Vaccine hesitancy also continues to underpin low vaccination rates. Developed at the beginning of the social media age, the HPV vaccine was hit hard by the antivax movement, which linked it to sterility, promiscuity, and early initiation of sexual activity. While these accusations are completely unfounded, they have resulted in many girls missing out on this life-saving tool.

To address these issues, PAHO recommends the implementation of single-dose vaccines to facilitate coverage, particularly among at-risk groups, and to optimize the use of scarce resources. Countries must also strengthen vaccine delivery strategies, including through community-based settings, and working alongside ministries of education to encourage vaccination at school. Campaigns that tackle the concerns of local communities, debunk myths, and promote the HPV vaccine as an essential tool in the prevention of cervical cancer, are also key.

When it comes to testing, PAHO recommends a transition away from Papanicolaou tests (Pap), which require a gynecological exam in a clinical setting, to biomolecular HPV tests, which can detect significantly more women at-risk of cervical cancer.

The newer HPV tests also enable women to self-sample via vaginal swab, which can be carried out in any setting, including a woman’s home, eliminating both the cultural and access barriers that prevent many women from getting screened. High-quality HPV vaccines and HPV tests are available for purchase through PAHO’s pooled procurement mechanisms, the Regional Revolving Funds, which continue to work with manufacturers to advocate for better pricing for the region.

The development of regional manufacturing of tests and vaccines could also positively impact affordability. As screening expands, so must services that treat women with high-risk HPV and pre-cancer. Simple and effective treatment at the primary care level is the best way to ensure access for women at highest risk of developing the disease.
The Americas has long been a world leader in the elimination of infectious diseases. With commitment and effort, we can also successfully eliminate cervical cancer.

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  1. Dr. Mitchell
    March 2, 2024

    While immunization isn’t a bad idea, more/significant/longer benefits would result in teaching people on how to prevent cervical cancer. The only known cause of cervical cancer is the human papilloma virus (HPV). The only documented way to spread high-risk HPV to the female cervix is by sexual contact with somebody who has HPV. It doesn’t cost much to teach people that individual decisions are putting people at risk for cancer. Unsafe sexual decisions place woman at risk for cervical cancer. Drinking alcohol puts women at high risk for breast cancer. Why don’t we teach this everywhere??? Have we given up??? Washing hands is the single best way to prevent the spread of influenza and COVID. Immunizations are fine, but knowledge is power and wise choices give us control. Spread the word!!

  2. We Know Better
    March 2, 2024

    Such New World Order hogwash. Poverty which is directly related to capitalist greed kills lots more people in the same region, I’d rather eliminate poverty. PAHO is already intertwined into the fabric of our health system but these people control power and will v*cin*ate all our young girls and women. As much as this comment may or may not be published we need to think, everything free may not be free. They can come with a heavy price for us and future generations.

    • Just Asking
      March 5, 2024

      I totally agree. They are bent on taking control of reproduction right from the Virgina. How more thorough can you get with population control?

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