Title : Can cervical cancer be eradicated globally?

Background: Cervical cancer has been the most common cancer in women worldwide. The mortality in USA and globally were the same prior to cervical cytology at 75%. However, in USA the incidence and mortality decreased after 1939 when screening cytology developed, but unchanged globally.  The question is, can the same principle be applied globally? The answer is clearly yes.

This is because the incidence and mortality in 2022 reported high at 662,301 and 48,189 respectively, But in USA that rate was 13490 and 4200. This remarkable difference is indebted to screening cytology.

Method: Looking back through the history, we can explain easily the benefit of screening by decreasing incidence and mortality in USA.

Although until 1940, the difference between USA and global incidence was the same with mortality rate of 75%. This high mortality rate was due to late diagnosis, and cancer was detected by physical examination.

In 1939-1940 Dr. Papanicolaou discovered cell cytology “Pap test” while looking on smear of vaginal secretion to diagnose ovulation. His discovery revolutionized cervical cancer detection with early diagnosis, which resulted in higher survival and lower mortality rate.

Discussion: After 1940  Dr. Joe Vincent Meigs in Boston, followed the women who were screened over 30 years. (1940-1970). He validated the effect of cytology screening that detects cancer early and this affected survival rate Additionally, he proved that earlier cancer detection leads to cure from cancer with radical hysterectomy that provides 90% 5 years survival rate. But cytology increased the rate of pre- invasive diseases. And these abnormalities can be eradicated with simple biopsies. As well as protecting women’s fertility.

Then, several theories raised about the cause of cancer, but none of theories validated until 1976 when Herald Zur Hausen isolated HPV 16/18 from cervical cancer specimen and the cause was established. He got Nobel Price in physiology and medicine in 1983 for his discovery.  Now question raised how to prevent cervical cancer.

In 1991 Ian Frazier and John Zhou discovered HPV particles that were base for vaccine development called Gardasil 4 and 9.

In 2006. HPV vaccine developed by several scientists and different companies in USA and the worldwide. Vaccine dropped the rate of dysplasia and warts between 40- 88% among vaccinated individual. So did among vaccinated individual the cancer. The vaccine was recommended by CDC to be used in 3 doses among girls 9-13. Prior to sexual activity and shortly after it was updated for women age 45 and boys after age 13. Vaccine recommended to be used in three dosage at start, 2 months and 6 months later.  Although, the one dose reported to be effective as well.  Vaccine dropped the rate of dysplasia and warts between 40- 88% among vaccinated individual.

HPV test furthermore replaced cervical cytology as cervical cancer screening.

Mortality: Although cancer incidence and mortality decreased, it was never at 0% until 2026 publication in Lancet where 0% mortality reported among girls vaccinated against HPV in past 5 years in England

Conclusion: Early cancer detection and vaccination against causative agent HPV resulted 0% mortality.

Here we have established that cervical cancer is a preventable, curable disease through the early detection and vaccination against HPV infection.  Safe sex education and establishing the screening and vaccination can eradicated the cervical cancer globally. 

To be updated shortly..