Australia has become a model country in the fight against human papillomavirus infection, responsible for many cancers (cervical, vagina, vulva, anus, penis, oral cavity, oropharynx, tonsils). Its vaccination program, launched in 2007, could enable it to virtually eliminate cervical cancer by 2035. But these data are often questioned by antivax, especially in France, which opposes to this vaccine. So we interviewed Professor Karen Canfell, Chair of Cancer Council Australia's Cancer Screening and Immunization Committee, responsible for coordinating this program.
Update: When and how did the human papillomavirus (HPV) vaccination program start in Australia?
Prof Karen Canfell: Australia was the first country to roll out a national HPV vaccination programme, starting in 2007, introducing school-based vaccination for girls with school and community catch-up up to the age of 26 years old, conducted until 2009. Boys were added to the program in 2013. A next-generation vaccine protecting against approximately 90% of cervical cancers in effectively vaccinated women was introduced in 2018. From From February of this year, the two-dose HPV vaccine given to adolescents aged 12 to 13 changed to a one-dose schedule. An ongoing catch-up program for young people who have not been vaccinated has been extended to include people under the age of 25.
What are the main results?
The vaccination program not only reduces the lifetime risk of cervical cancer and other HPV-related cancers in young vaccinees, it has also helped pass cervical cancer screening. uterus every two years to a five-year screening, but based on the detection of the virus. This new approach is expected to reduce cervical cancer mortality in Australia by approximately 25%.
What are the signs of being confident?
In the first five years of the program, an early indicator of success was a 77% decrease in the number of women aged 18-24 with HPV. Precancerous cervical abnormalities decreased by 34% among 20-24 year olds, meaning a much lower risk of developing cervical cancer. There has also been a marked decline in anogenital warts in women in their early twenties. Additionally, there has been a decline in the rate of genital warts in young heterosexual men even before they were included in the vaccination program. Over time, the vaccination program will also reduce the burden of other cancers linked to the virus, such as head, neck and anal cancers.
When will Australia become the first country to eradicate cervical cancer?
Based on current trends, we expect Australia to eliminate cervical cancer (according to the World Health Organization, with a rate of less than 4 per 100,000 women per year), as public health problem, by 2035. We have evidence that the goal is achievable through a combination of HPV vaccination, screening to treat pre-cancerous infections and other abnormalities, and referral to treatment for people with cancer at a early stage.
However, we must do more to reduce inequalities, particularly in access to screening. The Australian government is currently developing a draft national strategy along these lines. New testing interventions, such as universal access to self-collection of test samples, have already proven effective in reaching under-screened populations.
Are there movements against HPV vaccination in Australia?
There was no effective opposition. Government and non-government sectors conducted clear and effective communication campaigns, highlighting the benefits of the vaccine, and engaged with key stakeholders to support vaccine introduction and testing program transition.
