The opportunity to eliminate HPV cancers is one which is gaining support at the national and global level.
In 2020, the World Health Organisation (WHO) published a global strategy for the elimination of cervical cancer by 2030. Europe’s Beating Cancer Plan, published in 2021, has gone even further with its ambition to eliminate all HPV cancers and through its endorsement of gender-neutral HPV vaccination programmes.
‘Putting HPV on the Map: The State of HPV Prevention Programmes in the WHO European Region’, published during European Immunisation Week, is a new report, and the first of its kind, which examines the state of HPV prevention across the WHO European region (WHO EURO).
Supported by a grant from NOMAN is an Island, European Cancer Organisation’s Action Now on HPV project aims to support the implementation of effective vaccination and screening by identifying current policy, practice, implementation and gaps in the delivery of HPV vaccination programmes and screening across WHO EURO. This data collection and analysis will in turn inform our strategy to implement change in the region; identifying the countries in which we can support and encourage HPV advocacy, and in turn build towards the elimination of HPV related diseases.
HPV causes 100,000 cancers a year in WHO EURO; cancers which we can prevent through gender neutral HPV vaccination and cervical cancer screening. To do so would be a world leading example of how ambition and action can combine to eliminate cancer.
‘Putting HPV on the Map’ was produced by the Catalan Institute of Oncology (ICO) who were commissioned to produce a technical report that summaries the status of HPV prevention in Europe through a range of indicators including vaccination, cervical cancer screening, and HPV disease burden based on official WHO estimates.
Some of the key findings from the report are detailed below:
HPV cancers age-specific incidence and mortality rates in WHO EURO
- In WHO EURO, each year there are 66,821 new diagnosed cervical cancer cases and 30,608 deaths
- The highest incidence and mortality rates of cervical cancer are in Eastern Europe, with the Russian Federation accounting for approximately 1 in 4 new cervical cancer cases and deaths in WHO EURO.
- HPV causes approximately 21,000 cancers of the vagina, vulva, penis and anus in men and women each year.
- Head and neck cancers in the region are increasingly, particularly in men. However, the percentage of oropharynx cancer cases attributable to HPV among WHO EURO member ranges from 10%-70% (the CDC in the USA attributes 70% of oropharyngeal cancers to HPV). In addition, the inclusion of lip cancers, and cancers of the oral cavity make it difficult to estimate the true burden of head and neck cancers in the region.
HPV prevalence in women and men in WHO EURO
Survival rates for HPV related cancers in WHO EURO
*RS = Relative Survival
- 5 year RS in Eastern Europe for cervical cancer was 62%, vagina and vulva cancer: 48%, and 60% for penile cancer.
- Except for patients with laryngeal cancer, survival was better in women than in men and survival decreased with advancing age.
HPV vaccination in WHO EURO
*Slovenia and Greece will move to GNV programmes in 2022.
HPV vaccination coverage in WHO EURO
Vaccination coverage across the region varies considerably from over 90% to under 20% coverage. It is worth noting that the COVID pandemic has negatively impacted on coverage rates over the past 2 years.
HPV vaccination coverage in WHO EURO: girls
HPV vaccination coverage in WHO EURO: boys
*United Kingdom data based on 2020/21 figures
Cervical Cancer screening programmes in WHO EURO
- Cytology based cervical cancer screening programmes have successfully reduced the incidence and mortality of cervical cancer, but large randomised clinical trials have proved that HPV-based screening from age 30 provides 60-70% greater protection against precancerous lesions and invasive cancer than cytology (the WHO recommend primary HPV based screening)
- Cytology is still used in 91% of WHO EURO countries alone or combined with other tests. 38% of countries now recommend primary HPV based screening, but most of them are still transitioning from cytology-based screening.
- 66% of countries recommend to begin screening between the ages of 25-30 years, and 91% recommend to end screening between the ages of 6-69 years old.
- 82% of women aged 25-65 years had been screened for cervical cancer at least once in their lifetime, and 72% in the last 5 years.
This report therefore has provided us with an overview of the state of play in Europe, and the opportunities available to support advocacy efforts at the national level, and ultimately ensure that countries take the necessary steps to protect their populations against this virus.
You can access the full report via the link below.