Targeting cervical cancer with cure in mind
Fighting stigma to prevent cervical cancer
99% of cervical cancer cases are associated with high-risk strains of human papillomavirus (HPV) infection, which is mainly transmitted through sexual contact.1 The stigma related to these diseases means there is a lower awareness of the importance of prevention, screening and early diagnosis for cervical cancer.2,3
Dismantling this stigma is key to meaningfully improve outcomes, as most cervical cancers and related deaths can be avoided through HPV-based screening and vaccination.4 The World Health Organization global plan of action aims to eliminate cervical cancer by the end of the 21st century with increased HPV vaccinations being one of the key pillars of their plans.5
While prevention is the ultimate goal, we must continue to prioritise care for the approximately 604,000 women globally who are still diagnosed with cervical cancer each year.6
The state of cervical cancer globally
Cervical cancer is one of the most common gynaecological cancers and the ninth leading cause of cancer-related mortality in women worldwide.6 An analysis of data from 185 countries in 2018 found that in 79% of countries studied, cervical cancer is among the top three cancers affecting women younger than 45 years.4 The average age at diagnosis is 53 – lower than most other major cancer types – meaning that proportionally cervical cancer generates a greater loss of life years.4
For many women with early stage and locally advanced disease, cure is a possibility with early intervention.7-9 More than 90% of cervical cancers can be caught early through Pap tests and HPV testing, decreasing advanced diagnoses.9,10 However, there have been limited treatment advancements made in this setting, with radiotherapy, concurrent chemoradiation therapy (cCRT) and surgery remaining the standard of care for over two decades.7,9,11
Due to a variety of country-specific barriers, women in low income and low-middle income countries may not have adequate access to earlier screening or radiotherapy facilities, contributing to a number of global challenges in cervical cancer care.12,13 For those with access who undergo cCRT, about 20 to 40 percent will relapse despite initially responding well to treatment.14
We are working to help turn the tide against cervical cancer. Growing research shows HPV infection in cervical cancers is associated with certain immune pathways that may be targeted with cancer immunotherapies.15 We see the potential to harness the power of the immune system against cervical cancer as an important step towards changing the trajectory of this disease.
1. World Health Organization. Cervical cancer. Available at https://www.who.int/health-topics/cervical-cancer#tab=tab_1. Accessed February 2021.
2. Paz-Soldan VA, et al. LOW KNOWLEDGE OF CERVICAL CANCER AND CERVICAL PAP SMEARS AMONG WOMEN IN PERU, AND THEIR IDEAS OF HOW THIS COULD BE IMPROVED. Int Q Community Health Educ. 2010;31(3):245-263.
3. Mitiku I, et al. Knowledge about Cervical Cancer and Associated Factors among 15-49 Year Old Women in Dessie Town, Northeast Ethiopia. PLoS One. 2016;11(9):e0163136.
4. Arbyn M, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8:e191-203.
5. World Health Organization. World Health Assembly adopts global strategy to accelerate cervical cancer elimination. Available at https://www.who.int/news/item/19-08-2020-world-health-assembly-adopts-global-strategy-to-accelerate-cervical-cancer-elimination. Accessed February 2021.
6. World Health Organization. Globocan 2020 Fact Sheet. Available at https://gco.iarc.fr/today/data/factsheets/populations/900-world-fact-sheets.pdf. Accessed February 2021.
7. American Cancer Society. Treatment Options for Cervical Cancer, by Stage. Available at https://www.cancer.org/cancer/cervical-cancer/treating/by-stage.html. Accessed February 2021.
8. Cancer Research UK. About advanced cervical cancer. Available at https://www.cancerresearchuk.org/about-cancer/cervical-cancer/advanced/about. Accessed February 2021.
9. PDQ Adult Treatment Editorial Board. Cervical Cancer Treatment (PDQ®). PDQ Cancer Information Summaries [Internet]. Available at https://www.ncbi.nlm.nih.gov/books/NBK66058/#CDR0000062759__126. Accessed February 2021
10. American Cancer Society. The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer. Available at https://www.cancer.org/cancer/cervical-cancer/detection-diagnosis-staging/cervical-cancer-screening-guidelines.html. Accessed February 2021.
11. March C, et al. Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(4):iv72-83.
12. Chopra S, et al. Global Collaborations for Cervical Cancer: Can the East-West Alliance Facilitate Treatment for all? J Glob Oncol. 2019;5:1-5.
13. Hull R, et al. Cervical cancer in low and middle-income countries. Oncol Lett. 2020;20(3):2058-2074.
14. Liu X, et al. Predictors of Distant Metastasis in Patients with Cervical Cancer Treated with Definitive Radiotherapy. J Cancer. 2019;10(17):3967-3974.
15. Lee SJ, et al. Immunotherapy for human papillomavirus-associated disease and cervical cancer: review of clinical and translational research. J Gynecol Oncol. 2016;27(5):e51.
Veeva ID: Z4-31030
Date of Preparation: February 2021