I’m talking about cervical cancer. In Britain alone, 3,200 women are diagnosed with it every year, and two women die from it every day. Yet all these deaths are unnecessary.
I am a gynecologist with 30 years of experience diagnosing women with cervical cancer, and 15 years as a consultant in this field for the World Health Organization (WHO).
I literally reached the point of anger 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.
Unique among cancers is that we have the tools to do this: we have a great vaccine to prevent the viral infection that causes the disease, plus effective screening and treatment that prevents pre-cancer from becoming cancer.
We can also detect and cure cancer at an early stage, preventing death. But we don’t use these tools enough.
In Britain alone, 3,200 women are diagnosed with cervical cancer every year
The WHO launched its call for the eradication of cervical cancer in 2020 – and all 194 member states signed it. But cervical cancer continues to increase worldwide. Even in places where case numbers are falling – including Britain – they are not falling fast enough.
Britain is well placed to make improvements and just a few weeks ago the NHS set an ambition to eradicate cervical cancer by 2040, pledging to offer vaccines in settings such as libraries, and roll out self-sampling tests to try to solve some of the problems. with conventional smears.
Globally, there is still a long way to go, but cervical cancer can be defeated because 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 experience it at some point.
Most will clear the virus harmlessly, but in a small but significant proportion it persists and can cause cancer even years later.
If we can prevent HPV infection, we can prevent cervical cancer. That’s why we have the HPV vaccine. If given to girls aged 12 to 13 (before they come into contact with the virus), it prevents as many as 90 percent of cervical cancer cases; By comparison, doctors are happy if the flu shot is 50 to 60 percent effective.
And the HPV injection is extremely safe. Yet fewer than one in five girls worldwide are currently vaccinated: even in Britain – despite an excellent school program – around a quarter of teenagers are not vaccinated.
While the problems in poorer countries include costs, in the developed world it is mainly myths that stand in the way of the rollout of life-saving HPV vaccines.
This includes the belief that the vaccine, because it involves a sexually transmitted virus, may promote early sexual activity. Extensive research has shown this to be untrue.
There are stories of widespread side effects, such as pain and fatigue.
In fact, US statistics suggest that 1.8 in 100,000 (a rate of 0.0018 percent) of those vaccinated reported a serious adverse event – and because some of these events may have been coincidental, rather than actually caused by the vaccine caused, even this may be an overestimation.
Misinformation is a deadly game where lives are at stake.
In Denmark, the vaccine quickly gained 90 percent acceptance among 12-year-old girls. But in 2014, fear stories spread and the rate dropped to 40 percent.
Similar rumors in Japan saw vaccination rates drop 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, which brought acceptance back to 80 percent within a year.
Nevertheless, 26,000 Danish girls – and an entire generation of Japanese women – have missed out on near-perfect protection.
We must not only combat disinformation, but also provide accessible, correct information. For my book, I spoke to Morgan, a dental practice manager, who was 14 when the vaccine was introduced in the US – her mother let her decide if she wanted to take it, and she chose not to. She told me she just didn’t know its value.
Ten years later, Morgan was diagnosed with virulent cervical cancer, which kills 95 percent of those who contract the disease.
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, meaning the same vaccine works around the world. This makes herd immunity feasible.
So get your children vaccinated (or request a catch-up), ask friends if their children are protected – and remind them that this vaccine is only fully effective before exposure to HPV (i.e. before first sexual encounters). The vaccine alone, especially if given (as is now being done in Britain) to both teenage boys and girls, could eradicate cervical cancer. Screening can speed up that process.
In the UK you have a free screening program with regular test reminders – which we doctors in the US wouldn’t give before that! – and yet almost a third of women still don’t go to the meeting.
Cultural barriers contribute to low acceptance rates in certain communities, but some women are simply ‘too busy’.
This was the case for Kim, a working mother who told me she didn’t get around to it for seven years. When she finally went, she was diagnosed with cervical cancer. The treatment had terrible side effects, including incontinence. Screening could have saved her almost everything.
That is why I call on all of you to action. Go to screening; check to see if friends and family have been screened.
If you have the capacity, campaign: get involved with charities, put pressure on politicians, 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)