Tackling cancer in the Western Pacific

A collaboration between philanthropy and health researchers is poised to leverage Australia’s international leadership on the elimination of cervical cancer to reduce the incidence of the disease in the Western Pacific.

The NHMRC Centre of Research Excellence in Cervical Cancer Control (C4) has joined with the Minderoo Foundation to establish the cervical cancer program that will be rolled out in Papua New Guinea and Vanuatu. 

 

Many countries in the Western Pacific region do not have any cervical screening or the world-renowned HPV vaccination programs. And women do not have access to cancer treatment services. Australia, in contrast, has a strong record on tackling the disease, except for the inequities of screening participation and vaccination course completion among Indigenous communities. 

According to the first cervical cancer elimination report, released last week by the NHMRC Centre of Research Excellence in Cervical Cancer Control, Australia is on track to become the first nation to achieve the World Health Organisation’s coverage benchmarks for the disease, two years ahead of the 2030 deadline for the elimination of the disease. 

The WHO benchmarks are that 90 percent of girls are fully vaccinated with the HPV vaccine by 15 years of age; 70 percent of women are screening using a high-performance HPV test by age 35 and again by 45, and 90 percent of women identified with cervical disease receive treatment.  

The Memorandum of Understanding between the Minderoo Foundation’s Collaborate Against Cancer and the Cancer Council of NSW to establish the Western Pacific program will potentially provide almost $30 million to enable C4 and in-country partners to address the priority of eliminating the cancer and save the lives of 150,000 women in PNG alone. 

Professor Karen Canfell, Director of Cancer Research at the NSW Cancer Council, described the initiative as “just the beginning.’’ 

“We would have loved it to have started yesterday but we hope that of itself, it will galvanise action,’’ she says. “We need to work quickly.’’ 

“Australia is quite definitely in a real way leading in this space…and we have an important role to play but countries themselves will need to take the lead. This is a catalyst.’’ 

The intention is that Australia will help PNG and Vanuatu develop their own approaches based on the Australian model for eliminating cervical cancer. 

Caroline Henao, a board member of the PNG Cancer Foundation and a cervical cancer survivor, said the initiative would help empower women to undertake screening. “It would also encourage them to know this disease isn’t a death sentence but very much curable if detected early,’’ she says. 

The initiative is one of several approaches to the cervical cancer elimination strategy, with the Asian Development Bank, the Frazer Family Foundation (established by cervical cancer vaccine pioneer Ian Frazer), and in-kind contributions from the PNG and Vanuatu governments part of the strategy to secure vaccines, deliver HPV testing and build local health system capacity. 

Dr Steven Burnell, CEO of Minderoo Foundation’s Collaborate Against Cancer, said collaboration was the key to empowering the West Pacific nations to beat the disease. 

“This project delivers immediate impact in saving lives and will also involve scaling-up sustainable, in-country services for cervical cancer in Papua New Guinea and Vanuatu, proving a path to elimination and a roadmap for other nations to follow,’’ he says. 

The 2021 Cervical Cancer Elimination Progress Report recommended “…that persisting inequities in vaccination course completion and screening participation for Indigenous Australians are reduced…’’ by making the inequalities a policy priority in the programs, addressing barriers to recording Indigenous status and working with Indigenous Australians to develop culturally appropriate solutions. 

Australia’s National Cytology Screening Program, first established in 1991, and the world’s first national HPV vaccination program that started in 2007, have combined to halve the incidence of the disease and its mortality rate with a drastic reduction of HPV rates of infection and cervical precancerous lesions. Four years ago, the screening moved from the cytology to HPV-based screening, which is forecast to further reduce cervical cancer incidence by 20-30 percent.  

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