In the U.S. alone, over 33,000 HPV-related cancers are diagnosed annually among men and women and globally, there are over 630,000 cases. The theme of the briefing, “Let’s End HPV-Related Cancers” held in Washington, D.C. on June 27, 2019 centered around how to prevent the 6 cancers caused by HPV: cervical cancer, oropharyngeal cancers, anal cancer, penile cancer, vaginal cancer, and vulvar cancer. Representative Kathy Castor (D-FL-14) is a leader in the House of Representatives bringing legislation to the United States to meet the WHO goal to eliminate HPV-related cancers. The tools to eliminate these cancers do exist and Representative Castor expressed optimism for saving lives and never seeing these cancers again. Starting with cervical cancer, the approach of adding vaccination, screening, and treatment is necessary for elimination. Australia, Canada, and Rwanda are three countries which have declared they will be the first to eliminate cervical cancer and the U.S. must also show initiative with this mindset. 

     Cervical cancer cases across the globe follow a trend of gross inequities between and within countries90% of all cervical cancer deaths occur in low and middle income countries. There are also higher rates of cervical cancer in black and hispanic women, women in non-metropolitan areas, women with low socioeconomic backgrounds, and women who have never been or not been screened in the past 5 years. Additionally, systemic factors such as access to healthcare, no insurance, and immigration status are proven to affect a woman’s likelihood of developing cervical cancer. On May 19, 2019, Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO called “for coordinated action globally to eliminate cervical cancer” and stated “we have the tools to turn that commitment into a reality.” Also, during the 2019 meeting of the WHO Executive Board, more than 70 countries vowed support for the WHO secretariat to develop a 2020-2030 global strategy toward elimination of cervical cancer and countries such as Australia, Zambia, Malaysia, Kenya, Bhutan, Rwanda, and Canada have made public national commitments to this plan. The 2030 global strategy looks to ensure 90% of girls are fully vaccinated with the HPV vaccine by 15 years of age, 70% of women are screened with an HPV test at 35 & 45 years of age and 90% of women identified with cervical cancer disease receive treatment for precancerous lesions or invasive cancer. In the elimination of cervical cancer, there is also the opportunity to empower women and engage people in prevention and cure. 

     The global HPV vaccine works to consistently induce high level and long lasting strain-restricted antibody responses that prevent viral infection. It is critical that there is a focus on vaccinations on young people before they become sexually active. There is a limited uptake which is impacting HPV vaccines; in high income countries, there is vaccine hesitancy where coverage rates are only in the 60% range when they should be in the 80-90% range and in middle and low income countries the access to the vaccine is difficult for many due to its cost and the fact there is a supply shortage. 

     In clinical trials, the HPV vaccines did prevent virtually 100% of incident infections by the vaccine-targeted strains and premalignant lesions that arise from them. And, in national immunization programs with high coverage, they dramatically reduced the prevalence of targeted HPV infections and lesions. Other areas of research which should be prioritized for elimination of cervical cancer include therapeutic vaccines, better treatment options, and screening in low-resource settings. Although the United States does stand with the tools to end cervical cancer, there must be continued preclinical, clinical, and implementation research to propel the elimination of HPV-associated cancers. 

Sponsored by: The American Association for Cancer Research (AACR), Moffitt Cancer Center, and Biden Cancer Initiative 

Speaker: The Honorable Kathy Castor, U.S. Representative for the 14th District of Florida (FL-04)

Moderator: Gilbert S. Omenn, MD, PhD, Director for the Center for Computational Medicine and Bioinformatics University of Michigan, Chairman for Health Policy Subcommittee, American Association for Cancer Research

Keynote Speaker: Anna Giuliano, PhD, Founding Director, Center for Immunization and Infection in Cancer, Moffitt Cancer Center

Panelists: John T. Schiller, PhD, NIH Distinguished Investigator, Deputy Chief, Laboratory of Cellular Oncology, Center for Cancer Research, National Cancer Institute; Melinda Wharton, MD, MPH, Director, Immunization Services Division, National Center for Immunization and Respiratory Diseases, Center for Disease Control and Prevention; Vicki Bernard, PhD, Chief, Cancer Surveillance Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention; Julie S. Torode, PhD, Director of Special Projects, Union for International Cancer Control; Jason T. Mendelsohn, Patient Advocate and Survivor, SupermanHPV.com

 

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