Abstract
Abstract Cervical cancer is a major threat to women's health accounting for 528,000 new cases and 266,000 deaths annually around 2012, of which 85% occurred in low- and middle-income (LMICs). Substantial declines in cervical cancer incidence and mortality rates can be achieved by integrating HPV vaccination and cervical screening in public health services in LMICs. Since 2007, HPV vaccination has been introduced in national immunization programs in 73 countries, of which 33 are LMICs; in addition it has been introduced in pilot programs in another 17 countries, mostly in sub-Saharan Africa. It is particularly impressive that 7 out of 8 girls have access to HPV vaccination in Latin Region. So far, more than 270 million doses have been administered globally with excellent safety profile and high acceptance, despite the negative publicity surrounding HPV vaccination. The falling vaccine prices, possibility of new vaccines from China and India and the currently recommended two-dose schedule will make HPV vaccination more feasible. Screening is yet to be widely implemented in many LMICs and many of these countries lack the health care infrastructure and resources to introduce efficient screening programs. Screening has been sub-optimally performing in some LMICs for lack of adequate coverage, follow-up and quality assurance. A number of countries have introduced visual inspection (VIA) screening in their health services as opportunistic or pilot programs. HPV testing is the most effective cervical screening tool and HPV negative women are at very low risk for cervical cancer. Currently Mexico and Argentina have introduced HPV screening. The eventual availability of a simple, affordable, faster and accurate HPV tests will facilitate wider HPV screening in LMICs. Planned investments to implement HPV vaccination of single year cohorts of 9-13 year old girls and at least a single HPV screening of women between 30-59 will save many precious lives in developing countries. Citation Format: Rengaswamy Sankaranarayanan. Progress in scaling up cervical cancer prevention in health services of developing countries [abstract]. In: Proceedings of the AACR International Conference: New Frontiers in Cancer Research; 2017 Jan 18-22; Cape Town, South Africa. Philadelphia (PA): AACR; Cancer Res 2017;77(22 Suppl):Abstract nr IA1.
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