Australia is set to become the first country to eliminate cervical cancer
From painful waxes to ill-advised bleaching, it’s fair to say that, as women, we tend to put our vaginas through quite a lot of hassle. But there's one trauma which too many women have to suffer that is neither asked for nor welcome - and I don't mean childbirth. No, I'm talking about cervical cancer. Across the world, it is estimated that cervical cancer kills 270,000 women every single year.
Over the past few decades, governments have poured big money into trying to find ways to defeat the cancer, which affects younger women more than other forms of the disease. In fact, almost half of women with invasive cervical cancer - that is, cancer which has spread outside of the cervix - are under 35 at the time of diagnosis. But now Australia is set to become the first country in the world to succeed in eliminating it, according to the International Papillomavirus Society. So, how have they managed it? Well actually, it's surprisingly simple.
In 2007, the Australian federal government began providing a vaccine against Human Papillomavirus (HPV) - which causes 99 per cent of cervical cancer cases - for girls aged 12 to 13, and later extended the programme to also include boys. The two-stage jab is administered as part of an in-school programme, usually in a student's first year. In addition, any teenager under the age of 19 can access two doses of a three-stage version for free, an offer many appear to have taken up. In 2016, 78.6 per cent of 15-year-old girls and 72.9 per cent of 15-year-old boys had been vaccinated. Even better, it is believed that immunisation rates have further increased since then.
Correspondingly, the latest research published in the Journal of Infectious Diseases shows that there has been a significant drop in the rates of HPV among Australian women aged 18-24, falling from 22.7 per cent to just over one per cent. HPV is highly contagious and can be spread through sexual contact, so in providing the vaccination in the early teenage years, they were able to reach young people before they became sexually active. The virus, which particularly affects moist membranes such as the cervix, the anus, and the mouth and throat, contains over 100 strains.
“We are forecasting that over the next 30-40 years, rates of cervical cancer will drop from around the current 930 cases a year in Australia to just a few,” Professor Suzanne Garland, Director of the Centre for Women’s Infectious Diseases at the Royal Women’s Hospital, said in a statement.
It is predicted that young people who are receiving the vaccination now will further this dramatic fall. Older women - who will have become sexually active before the screening programme took effect - are being reminded to attend cervical screenings regularly. In 2017, Australia introduced a new HPV focused cervical screening programme which takes place less often than the traditional cervical smear but is believed to be more accurate. In the UK, the number of women attending screening appointments has dropped to the lowest levels seen in 20 years; at the same time, doctors have witnessed major reductions in the number of young women in the UK taking up the HPV vaccine.
However, in other countries, progress towards eliminating cervical cancer has been even more patchy. In the US, a full course of the HPV vaccine can cost as much as $450. According to the Henry J. Kaiser Family Foundation, less than 50 per cent of American girls and just 38 per cent of American boys between 13-17 had received it by 2016. In Japan, the take-up rate has fallen from around 70 per cent to around one per cent, thanks to fears over safety, mainly propagated online by parents.
Despite the urgency shown by many western governments and charities to address this problem, it is true that both North America and Oceanic countries already have some of the lowest rates of cervical cancer in the world. According to the World Cancer Research Fund International, 84 per cent of all cervical cancer cases occur in less developed countries - something that has led to them to describe the condition as "a case study in health equity". No matter how much rates drop, without these women gaining access to preventative vaccinations such as this, it will continue to be a major killer. On the contrary, when detected early, it actually has a very high survival rate.
So, what are the signs to look out for? Unfortunately, the illness has very few symptoms in its early stages. However, once it becomes more established, the most common warning sign is unusual bleeding, which can appear after sex, in-between periods or after the menopause. Others can include discomfort during sex or an unpleasant smelling discharge. If these occur, regardless of whether or not you've had the injection, the first thing you should do is book an appointment with your doctor.
All in all, it's clear to see the incredible power that modern medicine holds. To be able to take a hideously common virus that can have such long-term implications and all but wipe it out in the space of just over 10 years is no mean feat. But now we need to move the focus onto making sure that all women can benefit from this and not just those who happen to have the good fortune to be born in countries where the jab is readily available.