CERVICAL CANCER ELIMINATION PROGRAM

Abstract

Cervical cancer is one of the most common types of malignant neoplasms in women. According to Globocan, in 2018, 570000 new cases of cervical cancer and 311 thousand deaths from this pathology were registered. More than 85 % of cases of cervical cancer are registered in developing countries, where a third of all women are detected in the advanced stage of the disease.The association of cervical cancer with the chronic persistence of the human papillomavirus is unquestionable. To date, more than 200 types of HPV (human papillomavirus) are known, 12 of which are dangerous to humans and can cause the development of cervical cancer.The discovery of the link between HPV infection and breast cancer has changed the approach to cervical cancer screening in many ways. The fact that cervical cancer is primarily associated with an infectious agent has led to the development of new, more sensitive HPV-based screening tests for secondary prevention of cervical cancer and three HPV vaccines that are used for primary prevention.The only method that prevents the development of cervical cancer is HPV vaccination and cervical cancer screening. To date, there are 3 recombinant HPV vaccines: a bivalent HPV vaccine of type 16 and 18, a quadrivalent HPV vaccine of types 16, 18, 6 and 11, and a nine-valent vaccine of types 6,11,16,18,21,33. 45,52 and 58 . HPV vaccination has entered the immunization calendar in more than 100 countries where the experience of using the vaccine is more than 10 years. Large international randomized clinical trials have shown that HPV vaccines are safe and highly effective against persistent infection and precancerous lesions of the cervix in women (vaccine efficacy ≥93%).  These vaccines target high-risk HPV types, which are responsible for the development of about 90% of cervical cancer. Countries that achieved high vaccination coverage saw a 73-85% decrease in HPV prevalence and a 41-57% decrease in high-grade lesions among young women less than 10 years after the introduction of HPV vaccination.Organized, well-designed primary and secondary prevention strategies can have a positive impact on the incidence and mortality rates caused by cervical cancer.