Cervical cancer is the 7th most common cancer worldwide with over 600,000 cases diagnosed in 2020. However, around the world case numbers have been dropping dramatically. In Scotland, incidence of cervical cancer has plummeted by nearly 15% since 1993, and in Australia, researchers predict they’re on track to almost wipe out the disease completely. How has this happened? Could cervical cancer be cured?
What causes cervical cancer?
The main cause of cervical cancer is the virus called human papillomavirus (HPV) - the most common sexually transmitted infection. There are over 100 different types of HPV, 40 of which affect the genital area. Most people contract HPV at some point in their lives, but the majority have no symptoms and feel completely fine, often having no idea that they’re infected.
In most cases, the HPV infection isn’t harmful at all and will go away on its own – 90% of people will clear the virus in a short period of time. However, in a small number of people, HPV can linger in their bodies for many years and over time lead to the development of cervical cancer. Infection with HPV can also lead to a range of other cancers including anal, genital, and head and neck cancers.
It is a relatively slow-growing cancer that can take 5-20 years to develop, but diagnosing cervical cancer early gives the best chance of it being curable. Many countries around the world have introduced regular screening for cervical cancer with the hope of improving treatment outcomes for patients.
How is cervical cancer diagnosed?
While some of the symptoms of cervical cancer are easier to recognise, others can seem like normal symptoms of the menstrual cycle, or other conditions such as fibroids or endometriosis. This can make it hard to spot cervical cancer at an early stage if going off symptoms alone - and sadly the later a cancer is diagnosed, the less likely it is to be curable.
After a certain age, anyone with a cervix may be invited for a screening appointment, or smear test, to check for the earliest signs of cervical cancer, such as the appearance of abnormal cells. If signs of early cancer or precancerous cells are found, treatments are far less complicated and much more likely to succeed compared to if the cancer had gone unnoticed and developed much further.
Did you know that cervical cancer can also now be prevented with a vaccine?
Usually, the idea of a vaccine for cancer would sound far-fetched, because cancer is the result of the uncontrolled growth of cells, so how could we possibly vaccinate against our own cells? But thanks to years of research a strong link was discovered between HPV infection and cervical cancer - that 99.7% of cases are caused by persistent infection with the virus.
This meant that there was a target for vaccines! By exploiting this link between infection with a virus and cancer, and preventing infection happening in the first place, it is possible to prevent many cases of cervical cancer.
In 2007, Australia rolled out a national HPV vaccination programme to complement the cervical cancer screening programme that was launched in the 1990s. By 2016, the rate of cervical cancer had plummeted to 7.3 cases per 100,000 women each year, about half the global average. In 2018, researchers published a study predicting that if trends continue as they have, Australia will have effectively eliminated cervical cancer by 2066, with rates predicted to fall to 1 case per 100,000 women.
And as a Scottish cancer research charity (Worldwide Cancer Research was founded in St Andrews in 1979), we were delighted to see the free HPV vaccination programme launch in Scotland in 2008, aimed at schoolgirls from the ages of 11 to 13.
The uptake and effects have been impressive, as roughly 90% of eligible pupils received the vaccine, known as Gardasil, and a team of researchers from across Scotland found that the vaccine had nearly eradicated cases of pre-cancer in young women since its introduction.
Perhaps even more excitingly, even women who did not receive the vaccination seem to be protected by herd immunity created by the high uptake in the general population.
There have been some incredibly promising results, but there is still work to be done until no life is cut short by cervical cancer.
While cases in younger age groups that received the vaccine have dropped, many people were not able to benefit and therefore continue to be diagnosed.
People like our Curestarter Courtney's older sister Jade, who was just a few years too old to receive the HPV vaccine at school, and who was diagnosed with cervical cancer in 2023. Sadly Jade passed away just nine months later, leaving behind her devastated family, including her baby daughter Noor.
There are also rare cervical cancers that are not caused by HPV and therefore not covered by the vaccine. This means that it remains crucially important to continue looking for new cures for cervical cancer, until this disease can truly be eradicated for good.
Your cervical cancer FAQs:
How effective is the HPV vaccine in preventing cervical cancer?
The HPV vaccine is extremely effective in preventing cervical cancer and it has dramatically reduced the numbers of people getting this disease.
Studies in England show that the vaccine stops 90% of cervical cancer cases and that it can particularly help people in lower socio-economic groups.
Are there efforts to increase HPV vaccination rates globally?
The World Health Organisation has launched a worldwide programme to eliminate cervical cancer by 2040. This will involve the HPV vaccine being implemented in more countries, as well as vital screening and treatment of pre-cancer.
Is the HPV vaccine effective in preventing other types of cancer?
Yes. The HPV vaccine protects against cervical cancer but also other cancers that are linked to the HPV virus. These include mouth cancer, anal cancer, penile cancer, vulval cancer and vaginal cancer.
Are there ongoing research efforts to improve HPV vaccines?
There are currently six safe and effective HPV vaccines that have been developed thanks to scientific breakthroughs. In the UK we recently changed to using one called the Gardasil®9 vaccine which is effective against 9 types of the HPV virus.
Researchers around the world are investigating new vaccines that could protect against even more HPV types and are using new technologies to create even better cures so that one day no life will be cut short by cervical cancer.
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