It will eliminate cervical cancer

Will women in Sweden avoid the risk of cervical cancer in just a few years?

He hopes and Joachim Dillner, professor of infection epidemiology at Karolinska Institutet, believes. He has conducted research for many years on this type of cancer and the cancer-causing variants of the human papillomavirus, HPV, which are the cause.

He is now leading the research study that will evaluate what is called the Persistent Extinction Project. The researchers’ hypothesis is that the eradication of cervical cancer could be accelerated by offering HPV vaccines and systematic HPV screening to women born in 1994-1999.

– Vaccination is currently taking place About 200 women a day across the country. It is very good! He tells the medical world.

Global elimination strategy

Almost all cases of cervical cancer are caused by human papillomavirus, a very common sexually transmitted infection.

The World Health Organization WHO I fired one Global strategy Against cervical cancer. It aims to eliminate the disease. The World Health Organization defines eradication as four or fewer new cases per 100,000 women per year.

In order to achieve this goal, some intermediate goals must be achieved by 2030. One goal is that 90% of all women should receive the HPV vaccine by the age of 15 years.

You want to get rid of the disease in the near future

In Sweden, all girls are now offered the HPV vaccine as part of the school vaccination programme. Since 2020, boys also receive the same offer.

Among women who Born in the years 1994-1999, however, relatively few were vaccinated against HPV. Those who did received the older vaccine – which only protected against four cancer-causing HPV variants, while the newer monovalent vaccine – which protected against nine variants.

Therefore, experts believe that interventions specifically targeted to these groups of women should be a highly effective tool to get rid of the disease faster.

– Because cervical cancer goes To eliminate it, it is important that we no longer allow this to happen. “We want to see the disease disappear in the near future, and with the wonderful support we now have from all over the country, I believe it is possible,” says Joachim Dillner.

Decisions in all regions

In 2021, the Swedish Parliament issued a so-called declaration that Sweden must accelerate the elimination of cervical cancer. Later that year, the Swedish municipalities and regions, SKR, as reported by Läkemedelsvärlden, recommended that all regions participate in this.

The recommendation was for We offer all women born between 1994 and 1999 the HPV vaccine and free HPV testing.

The Stockholm area started directly with its own money. Later, the state pushed for funds for the vaccination effort, and region after region decided to join the project.

– Now we have It received decisions in all 21 regions, and this is perhaps very rare when it comes to this type of investment, says Joachim Dillner.

Vaccine coverage varies

The last region to begin so-called catch-up vaccination was the Blekinge region, which began in August of this year. On the interactive map on the website www.cancercentrum.se Is it possible to know the percentage of women in the relevant age group who have had sufficient time to be vaccinated in each region?

Vaccine coverage varies for Between 7.2 and 41.1 percent.

On average, this percentage is about 40% of the approximately 356,000 women in the target group.

Does the hypothesis hold up?

The goal is to reach at least 70% equal vaccine coverage by the end of 2024.

– that it The level required to crash the infection. We want to achieve a high degree of immunity so that we stop the circulation of cancer-causing virus variants.

If the planning works, Joachim Dillner and his fellow researchers should be able to tell you three years later, in 2027, whether their hypothesis was correct. Then they could get results that show whether vaccination efforts are actually stopping the spread of cancer-causing HPV.

– It took a while Longer time to begin vaccination across the country than we originally thought. But I think it is still possible for us to finish the study by 2027, says Joachim Dillner.

– Differences in interest among women

He says regions often have to put in a lot of effort to convince young women to come to vaccination and testing clinics.

-At first this usually happens About ten percent of those who hold on to the lock are really into it and come as soon as they get the chance. They may have thought it was expensive to get vaccinated before, but it will come as soon as it becomes free.

– Then there are between 10 and 40 percent who come when they receive a message with an invitation. Others are often not very motivated and you have to work to reach them.

– might happen Examples include sending reminders and offering vaccination where you are anyway. Among the receptions with the best statistics in Västra Götaland are the ones held in the Nordstan shopping center.

next step

When school vaccination and continued additional vaccination stop the spread of the virus, it will be time for the next step in the fight against cervical cancer.

Then comes the national Quality Registry for Cervical Prevention to coordinate various efforts to find women who have already been infected with HPV.

Care must then follow up on those who, upon sampling, are found to be infected with HPV. In many cases, the infection resolves on its own, but it can also cause cell changes and eventually cancer.

With early treatment You can reduce this risk.

School vaccinations should continue

If all goes as planned, within not many years, cervical cancer will be so rare that it can be said to be eradicated.

It’s mean though This does not mean that we can stop vaccinating girls and boys against HPV at school, stresses Joachim Dillner.

– No, we cannot remove these vaccinations because there are more countries in the world than Sweden. Some countries will find it very difficult to stop HPV, and this means we need to continue to protect ourselves from the virus.

The examination may be stopped

However, hopefully in the long term we will no longer need a cervical cancer screening programme.

– About infection and The cancer is no longer there, and we should of course not keep checking for it.