I'm talking about cervical cancer and in the UK alone, 3,200 women are diagnosed every year and two women die from it every day. But all these deaths are unnecessary.
I am a gynecologist with 30 years of experience diagnosing cervical cancer in women and 15 years as a consultant on this topic for the World Health Organization (WHO).
I literally got so angry seeing so many deaths and having to tell people they had cancer that could have been prevented. We must do more to protect women – and ultimately eradicate cervical cancer. Because it can be eliminated.
We are the only type of cancer with the means to do this: we have an amazing vaccine to prevent the viral infection that causes it, and effective screening and treatment methods to prevent precancerous lesions from developing into cancer.
We can also detect and cure cancer in its early stages, thereby preventing death. But we don’t use these tools enough.
In the UK alone, 3,200 women are diagnosed with cervical cancer every year
In 2020, WHO launched its call to eliminate cervical cancer – and all 194 member countries joined the call. But cervical cancer continues to increase worldwide. Even where case numbers are falling – including in the UK – they are not falling fast enough.
The UK is in a good position to improve and just a few weeks ago the NHS set a target of eliminating cervical cancer by 2040, pledging to offer vaccines in settings such as libraries and provide self-collection testing to address some of the Solve problems with conventional smear screening.
Globally, there is still a long way to go, but cervical cancer can be beaten as at least 99 percent of cases are caused by “high-risk” strains of the sexually transmitted human papillomavirus (HPV). This infection is very common – 80 percent of women have it at some point.
Most clear the virus harmlessly, but in a small but significant proportion it persists and can even cause cancer years later.
If we can prevent HPV infection, we can prevent cervical cancer. That's why we have the HPV vaccine. It is given to girls ages 12 to 13 (before they come into contact with the virus) and prevents a staggering 90 percent of cervical cancer cases. In comparison, doctors are satisfied if the flu vaccination is 50-60 percent effective.
What is cervical cancer?
Cervical cancer affects the lining in the lower part of the uterus.
The most common symptom is unusual bleeding, e.g. B. between periods, during sex or after menopause, but other signs can also include:
- Pain during sex
- Vaginal discharge that smells
- Pain in the pelvis
Causes can be:
- Age – more than half of those affected are under 45
- HPV infection – which affects most people at some point in their lives
- Smoking – responsible for 21 percent of cases
- Contraceptive pill – linked to 10 percent of cases
- have children
- Family history of cervical cancer or other cancers such as vaginal cancer
Source: Cancer Research UK
And the HPV vaccine is extremely safe. But worldwide, fewer than one in five girls are currently vaccinated: even in the UK – despite an excellent school program – around a quarter of teenagers are not vaccinated.
While in poorer countries the main issue is cost, in the developed world it is primarily myths that are hindering the introduction of life-saving HPV vaccines.
This includes the belief that the vaccine can promote early sexual activity because it is a sexually transmitted virus. Extensive research has shown that this is not true.
There are reports of widespread side effects such as pain and fatigue.
In reality, statistics from the US suggest that 1.8 per 100,000 (a rate of 0.0018 percent) of those vaccinated reported a serious adverse reaction – and that's even because some of these events may have been coincidental rather than caused by the vaccine This may be an overestimation.
Misinformation is a deadly game with lives at stake.
In Denmark, the vaccine quickly achieved 90 percent acceptance among 12-year-old girls. But in 2014, horror stories spread and the rate fell to 40 percent.
Similar rumors in Japan claim that vaccination rates have fallen from 74 percent in 2013 to less than 1 percent in 2016.
The fears were unfounded and in 2017 the Danes launched a public information campaign, the acceptance of which rose again to 80 percent within a year.
Yet 26,000 Danish girls – and an entire generation of Japanese women – have missed out on almost perfect protection.
Not only do we need to combat misinformation, we also need to provide accessible and accurate information. For my book, I spoke to Morgan, a dental practice manager who was 14 when the vaccine was rolled out in the US – her mother let her decide whether she wanted to take it, and she chose not to. She told me she just didn't know what it was worth.
Ten years later, Morgan was diagnosed with malignant cervical cancer, which kills 95 percent of those affected.
After grueling treatment, she is cancer-free, but she wishes she had been given the facts she needed to make an informed decision.
“High-risk” HPVs are easier to eliminate than viruses like flu and Covid-19 because they don’t constantly produce new variants, so the same vaccine works everywhere in the world. This makes herd immunity achievable.
So get your children vaccinated (or ask for a follow-up appointment), ask friends if their children are protected – and remind them that this vaccine is only fully effective when exposed to HPV viruses (i.e. before the first sexual encounters). The vaccine alone could eliminate cervical cancer, particularly if given to both teenage boys and girls (as is currently the case in the UK). Screening can speed up this process.
The UK has a free screening program with regular test reminders – something we doctors in the US wouldn't give for that! – and yet almost a third of women still do not take part.
Cultural barriers contribute to low acceptance in certain communities, but some women are simply “too busy.”
That was the case with Kim, a working mom who told me she just couldn't do it – for seven years. When she finally left, she was diagnosed with cervical cancer. The treatment had terrible side effects, including incontinence. The screening could have saved her almost everything.
That's why I call on all of you to take action. Go to the screening; Check if friends and family have been verified.
If you have the capacity, campaign: get involved with charities like the excellent Jo's Cervical Cancer Trust, put pressure on politicians and tell anyone who will listen that cervical cancer can and should be eliminated.
- Linda ECKERT is a professor of obstetrics and gynecology at the University of Washington. Her book Enough: Because We Can Stop Cervical Cancer is published by Cambridge University Press (£20).
AS JULIET RIX TELLS