HPV vaccines and regular screening offer hope for a future free of cervical cancer
4 minutes read
- For now, early treatment and fertility preservation can significantly improve outcomes, according to an expert from Cleveland Clinic’s global network during Cervical Cancer Awareness Month.
January 2024. With vaccines available against human papillomavirus (HPV) and the ability to remove abnormal cells before cancerous lesions develop, cervical cancer could become a disease of the past for future generations, according to an expert from the global health system Cleveland Clinic, speaking during Cervical Cancer Awareness Month (January).
Cervical cancer is the fourth most common cancer among women worldwide and is mainly caused by persistent infection with high-risk types of HPV, according to the World Health Organization (WHO). In its recent publications, the WHO estimates that there were 604,000 new cases of and 342,000 deaths from cervical cancer in 2020.
“The good news is that cervical cancer is preventable and also highly treatable, especially if detected early,” says gynaecological oncology surgeon Owen Heath MBBS MRCOG PhD, of Cleveland Clinic London.
According to Dr. Heath, a combination of HPV vaccines and regular screening is needed to eliminate cervical cancer. “While studies in the UK and Australia have highlighted the effectiveness of HPV vaccination programmes in reducing the incidence of cervical cancers and pre-cancers, more research is needed,” he says. “Regular screening remains vital, as some people may choose not to have the vaccine, or in some countries the vaccine may not cover all high-risk types of HPV. In extremely rare cases, a cervical cancer that is not directly linked to HPV could develop.”
Vaccines are normally given to school-age children and to adults up to the age of 45, after which the likelihood of developing cancer from HPV is lower, although regular cervical screening should continue. Dr. Heath notes that the vaccines are not just for women; as well as passing on the disease, men are also at risk of health problems caused by HPV strains, such as head and neck cancers.
Dr. Heath says that cervical cancer can develop slowly, with precancerous cells becoming cancerous over many years, which is why regular screening is paramount. Although guidelines vary from country to country, he recommends that women see a doctor to ask how often they need screening based on their individual risk profile. According to Dr. Heath, women over 65 may stop screening if previous results have been normal, but since cervical cancer can develop at any age, it is important to consult an expert if there are gynaecological symptoms.
The most common screening test combines HPV testing with a smear test. A cervical sample is tested for high-risk HPV subtypes; if high-risk subtypes are detected, the cells are examined for abnormalities, adds Dr. Heath.
If a high-risk form of HPV is found in a woman, she will need to be monitored carefully, usually through annual screening. “In most cases, the body’s own immune system can clear the infection, but if it persists, it can cause abnormalities in the cells of the cervix which, if left untreated, can develop into cervical cancer. If there is evidence of persistent HPV infection or cytological abnormalities, a detailed examination of the cervix called a colposcopy should be carried out. This is a quick and effective way to reach a diagnosis. Precancerous areas on the cervix can be treated at the same time by removing or excising these cells,” says Dr. Heath.
If a patient is diagnosed with cervical cancer, surgical removal of the cancerous tissue is very effective if the cancer is detected at an early stage, says Dr. Heath. He says that at this stage fertility-sparing procedures could be offered, such as a trachelectomy, in which the cervix is removed but the uterus remains. Later-stage cancers are treated with a combination of radiotherapy and chemotherapy.
About Cleveland Clinic
Cleveland Clinic is a nonprofit multispecialty academic medical centre that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based on the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States.
U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 72,500 employees worldwide are more than 5,050 salaried physicians and researchers, and 17,800 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,500-bed health system that includes a 173-acre main campus near downtown Cleveland, 21 hospitals, more than 220 outpatient facilities, and locations in northeast Ohio; southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England.
In 2021, there were 10.2 million outpatient visits, 304,000 hospital admissions and observations, and 259,000 surgeries across Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries.
Visit us at clevelandclinic.org. Follow us at twitter.com/ClevelandClinic. News and resources available at newsroom.clevelandclinic.org.
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