Tackling inequalities to achieve cervical cancer elimination
Emma Cerrone, Public Health Business Unit Director
Merck Sharp & Dohme (UK) Limited has funded and had editorial control over this article
The UK has the opportunity to eliminate cervical cancer, a disease which still accounts for nearly 3,800 new diagnoses in women each year.1 After many years of falling incidence rates,2 the World Health Organisation’s cervical cancer elimination ambition, published in 2020, set out clear targets – 90% of girls vaccinated, 70% of women screened and 90% of those with cervical disease receiving treatment by 2030 – to guide how the UK and other countries can achieve the end of cervical cancer as a public health threat.
This opportunity is made a reality through preventative measures focussed on human papillomavirus (HPV) – which is the cause of more than 95% of all cervical cancer cases.3 MSD is proud to be investing in and supporting HPV elimination – evidenced by our commitment to the recently launched HPV Coalition – as we do with two further diseases, HIV and Hepatitis C.
HPV infection doesn’t discriminate – 80% of us will experience it in our lifetimes,4 though the majority of cases are asymptomatic. Cervical cancer, however, disproportionately affects certain groups – incidence rates are 65% higher in the most deprived socioeconomic quintile compared with the least, and around 520 cases each year in England are directly linked with deprivation.2 Why is this the case?
Much of this disparity can be traced back to equal access to preventative interventions – namely vaccination and cervical screening. The UK’s school-based vaccination delivery model should be providing free equitable access to immunisation, but variations persist and young people across the UK are continuing to miss out on vaccinations based on their location, family income levels and ethnic background:
- In areas of poor school attendance, students are likely to miss vaccination opportunities5
- High levels of deprivation have been linked directly to low vaccine uptake, with parents less likely to respond to consent forms6
- Research has shown that girls from ethnic minority backgrounds are typically less likely to be vaccinated7
“At Jo’s, our vision has been for a future where cervical cancer is a thing of the past for many years. Elimination is within our reach, but we need commitments and an articulated vision from the UK Government to get us there. There are many barriers to accessing cervical cancer prevention programmes across the UK, and action is needed to address them, and put us on the path to elimination.” – Samantha Dixon, CEO, Jo’s Cervical Cancer Trust
National and local leaders need to work in tandem to put addressing inequalities at the heart of the UK’s HPV prevention activities. This starts with a strong commitment from health leaders, and we now need concerted support and action from parliamentarians and the Government to ensure that cervical cancer elimination is achieved equitably, and not left as a disease of the few. At MSD, we are firmly committed to playing our part.
GB-NON-07194 March 2023
1ICO/IARC HPV Information Centre, United Kingdom – Human Papillomavirus and Related Cancers Fact Sheet 2021, October 2021. Available at: https://hpvcentre.net/statistics/reports/GBR_FS.pdf
2Cancer Research UK, Cervical cancer statistics, accessed February 2023. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer
3World Health Organisation, Cervical Cancer, accessed March 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
4NOMAN, HPV Facts, accessed February 2023. Available at: https://www.nomancampaign.org/hpv-facts
5Forster et al., Girls’ explanations for being unvaccinated or under vaccinated against human papillomavirus: a content analysis of survey responses, December 2015. Available at: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-2657-6
6Paterson et al., Strengthening HPV vaccination delivery: findings from a qualitative service evaluation of the adolescent girls’ HPV vaccination programme in England, June 2019. Available at: https://researchonline.lshtm.ac.uk/id/eprint/4653464/1/Paterson-etal-2019-Strengthening-HPV-vaccination-delivery.pdf
7Forster et al., Exploring human papillomavirus vaccine refusal among ethnic minorities in England: A comparative qualitative study, March 2017. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599953/
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