Dr. Danielle Rodin, radiation oncologist at the Princess Margaret Cancer Centre, discusses new research findings on the economic impact of cervical cancer left untreated in low- and middle-income countries. (Video: UHN)
Toronto (May 28, 2019 – A first-of-its-kind study is reporting that millions of women in low- and middle-income countries will need life-saving radiotherapy to treat their cervical cancer, despite the growth of essential human papilloma virus (HPV) vaccination prevention programs.
The availability of radiotherapy in these regions would generate millions of productive life years and billions of dollars in economic benefits for their families and communities.
The study modelled the long-term demand, benefit and cost of implementing a 20-year strategy for radiotherapy to treat cervical cancer in low- and middle-income countries between 2015 and 2035, alongside a simultaneous vaccination program.
Low-income and middle-income countries include those with a per capita gross national income of less than US$12,000 a year.
The research entitled "Scale-up of radiotherapy for cervical cancer in the era of human papillomavirus vaccination in low-income and middle-income countries: A model-based analysis of need and economic impact," by lead author Dr. Danielle Rodin and senior author Dr. Michael Milosevic in the Radiation Medicine Program, Princess Margaret Cancer Centre, is published in the May 28, 2019 online edition of The Lancet Oncology.
In the designated 20-year-time span, the study estimated that 9.4 million women in these countries will require radiotherapy – the gold standard for curing women with more advanced cervical cancer. This would result in a net benefit to the economies of these countries of $151.5 billion over the same time period as a direct result of women living longer, more productive lives.
HPV vaccination would result in a 3.9 per cent reduction in cervical cancer incidence over the study period – assuming a best case scenario of vaccinating every 12-year-old girl in the world starting in 2014. By 2072, when the first vaccinated cohort reaches 70 years of age, there would be a 22.9 per cent reduction in incidence, still leaving 41.6 million in need for radiotherapy over that time period.
Almost all cervical cancers are caused by human papillomavirus (HPV), a sexually transmitted infection. There are more than 100 types of HPV, of which more than 40 can cause cervical cancer. Persistent HPV infections can sometimes develop into cervical cancer if not treated.
"These are women in their prime who are working, caring for children, and contributing to their communities. We have made huge progress in tackling other infectious disease and in reducing maternal mortality, so that women are now living long enough to develop diseases such as cancer and heart disease," says Dr. Danielle Rodin, Clinician–Investigator and Radiation Oncologist, Princess Margaret Cancer Centre.
"Vaccination is hugely important, but we can't neglect the millions of women who are contracting cervical cancer and dying in pain without access to treatment. These are women who have curable cancers – even advanced cervical cancer can be cured with radiotherapy. The possibility exists to make this treatment universally available."
Fast Facts
- Global cervical cancer burden falls disproportionately upon women in low and middle-income countries: approximately 90 per cent of deaths from cervical cancer occur in low- and middle-income countries
- Cervical cancer is the most commonly diagnosed cancer in 28 countries and the leading cause of cancer death in 42 countries, many of which are in Sub-Saharan Africa and South-East Asia
- World-wide cervical cancer deaths are expected to rise to more than 440,000 deaths a year by 2030 – up from about 260,000 deaths currently – roughly a 60 per cent increase and double the expected maternal mortality from pregnancy complications
- Incomplete vaccine coverage, the long lag time for cancer growth after HPV infection, and a growing population mean that millions of women will require radiotherapy to prevent death
- Study demonstrates the need for a comprehensive approach to cervical cancer prevention and treatment, which includes both vaccination to prevent the disease and radiotherapy to cure woman who already have the disease
- Seven UN agencies under the United Nations Interagency Task Force on the Prevention and Control of Non-communicable Disease (NCDs) have established a Joint Program to prevent and control cervical cancer through global leadership and technical assistance to support governments and their partners build and sustain programs for prevention and treatment
- The Joint Program will build on the world's collective endeavours so that in a generation, death from cervical cancer ceases to be a public health issue
About Princess Margaret Cancer Centre
Princess Margaret Cancer Centre has achieved an international reputation as a global leader in the fight against cancer and delivering personalized cancer medicine. The Princess Margaret, one of the top five international cancer research centres, is a member of the University Health Network, which also includes Toronto General Hospital, Toronto Western Hospital, Toronto Rehabilitation Institute and the Michener Institute for Education at UHN. All are research hospitals affiliated with the University of Toronto. For more information, go to
www.theprincessmargaret.ca.
