Abstract
WHO has put forth a challenge for the next century to reduce the incidence of cervical cancer globally to fewer than four cases per 100 000 women, a level equated with elimination. 1 WHOTo eliminate cervical cancer in the next 100 years, implementing an effective strategy is critical. https://www.who.int/news/item/04-02-2020-to-eliminate-cervical-cancer-in-the-next-100-yearsDate accessed: May 15, 2021 Google Scholar Globally, the range of cervical cancer incidence is far from the WHO goal, with one of the lowest human development index (HDI) countries Eswatini at 75·3 cases per 100 000 women, 2 Arbyn M Weiderpass E Bruni L et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020; 8: e191-e203 Summary Full Text Full Text PDF PubMed Scopus (1118) Google Scholar and the higher HDI regions at 10·4 cases per 100 000 women. 3 Bray F Ferlay J Soerjomataram I Siegel RL Torre LA Jemal A Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68: 394-424 Crossref PubMed Scopus (45408) Google Scholar Historically, cervical cancer incidence has steadily decreased because of opportunistic and organised screening programmes. Between 1990 and 1995, Finland reached a cervical cancer incidence of fewer than four cases per 100 000 women through organised screening; nonetheless, a subsequent decrease in participation in screening among women aged 30–35 years led to an increased incidence within a 5-year timeframe. 4 Harper DM Nieminen P Paavonen J Lehtinen M Cervical cancer incidence can increase despite HPV vaccination. Lancet Infect Dis. 2010; 10: 594-595 Summary Full Text Full Text PDF PubMed Scopus (31) Google Scholar Cytology as a primary screen has been replaced by primary human papillomavirus (HPV) cervical screening, which has a 70% greater protection against invasive cervical cancer than cytology. 5 Ronco G Dillner J Elfström KM et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014; 383: 524-532 Summary Full Text Full Text PDF PubMed Scopus (1020) Google Scholar Sustainability of neutralising antibodies induced by bivalent or quadrivalent HPV vaccines and correlation with efficacy: a combined follow-up analysis of data from two randomised, double-blind, multicentre, phase 3 trialsThe observed significant differences in the immunogenicity of the two vaccines are in line with the differences in their cross-protective efficacy. Protective HPV vaccine-induced antibody titres can be detected up to 12 years after vaccination. Full-Text PDF
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