We asked our SCPN team and friends what they thought was the most interesting paper that had come across their desks this year. We are delighted that our Chief Medical Officer Dr Catherine Calderwood has provided us with some thoughtful reading with a paper that highlights the possibility of global elimination of a form of cancer through vaccination.

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.

Kate T Simms, Julia Steinberg, Michael Caruana et al.

The Lancet Oncology

https://doi.org/10.1016/S1470-2045(18)30836-2

Why this paper?

This impactful paper models the potential for the elimination of cervical cancer worldwide by the end of this century through worldwide application of effective vaccination programs. The challenge to deliver an effective vaccination program is greatest in low and middle income countries and particularly in countries for religious and/or cultural beliefs, where education and information is less available.

However, recently evidence has emerged that when government agencies get behind the medical efforts to truly deliver a high penetrating vaccination program, there can be significant success in access and uptake of HPV vaccination programs in low income populations. In March 2018 the WHO called on countries in the South-East Asia region to accelerate their efforts towards cervical cancer elimination. Cervical cancer is a substantial burden in South-East Asia, with an estimated 158 000 new cases and 95 766 deaths reported in 2018. Improvements in screening, diagnosis, and treatment are urgently needed, but widespread vaccination against human papillomavirus (HPV) will have the largest effect towards eliminating the disease. There is emerging evidence that effective government sponsored vaccination programs are being effective in low income populations, (Current status of human papillomavirus vaccination in India’s cervical cancer prevention efforts. Rengaswamy Sankaranarayanan et al. Lancet Oncology Volume 20, 11, 637-644, November, 2019).

National, publicly funded HPV vaccination programmes, high uptake of vaccination and screening, and access to high-quality diagnosis and treatment, are essential to tackle the global burden of cervical cancer. However, the disparities that persist in terms of access to vaccination and screening will delay worldwide elimination—a stark warning for countries of all income levels. Political commitment for evidence-led, well-funded, accessible prevention programmes combined with education and awareness campaigns to combat dangerous misinformation will bring countless societal and economic benefits.