Call to Action - Towards the Elimination of Cervical Cancer in the Pacific Islands

C4 CRE team members Marion Saville, Julia Brotherton, Andrew Vallely, and Deborah Bateson met with key organisations in Suva, Fiji on 5-6 December 2019 and agreed to a Call to Action on the global target to achieve elimination of cervical cancer as a public health problem, (below), noting the current high burden of cervical cancer in the Pacific and the current lack of adequate vaccination, screening and treatment there.

L-R: Andrew Vallely, Julia Brotherton, Marion Saville, and Deborah Bateson

Meeting Delegates in Suva, Fiji on 5-6 December 2019

Call to Action – Towards the Elimination of Cervical Cancer in the Pacific Islands

Delegates from the following countries and organisations met in Suva, Fiji on 5-6 December 2019 and agreed the Call to Action below:

Delegates from Papua New Guinea, Vanuatu, Solomon Islands, Kiribati, Federated States of Micronesia, Fiji and Samoa together with representatives of the Pacific Society for Reproductive Health, Papua New Guinea Obstetrics and Gynaecology Society, Fiji Obstetrics and Gynaecology Society, Papua New Guinea Institute of Medical Research, Cervical Cancer Prevention in the Pacific, The Pacific Community (SPC), VCS Foundation, Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Kirby Institute at the University of New South Wales, Family Planning Australia, Australian Cervical Cancer Foundation, Fiji Cancer Society, Fiji National University, University of Otago, National University of Samoa and Victoria University. Also present were representatives of the United Nations Population Fund and the United Nations Children’s Fund.

We agreed to the following principles:

  1. We support the global target to achieve elimination of cervical cancer as a public health problem, noting the current high burden of cervical cancer in the Pacific and the current lack of adequate vaccination, screening and treatment.
  2. In line with the World Health Organization (WHO) draft targets for 2030, in the Pacific our targets are:
    1. 90% of girls are fully vaccinated against human papillomavirus (HPV) by 15 years of age.
    2. 70% of women have had an HPV screening test between 30 – 39 years of age and a second HPV test between 40 – 49 years of age[1].
    3. 90% of women identified with cervical pre-cancer and cancer have received appropriate treatment and care
  3. We support the principles of equity in striving for the elimination of cervical cancer in the Pacific so that no woman or community is left behind.
  4. We support the principle of meaningful collaboration between Pacific Island nations in planning, procurement and knowledge sharing.

We are committed to the following actions:

  1. Raising awareness of cervical cancer in the Pacific and its impact on families and communities and strengthening advocacy for elimination.

Vaccination

  1. Exploring funding options including public-private partnerships for ongoing HPV vaccination in the Pacific.
  2. Urging Pacific Island governments to include HPV vaccination against HPV onto existing immunization schedules.

Screening

  1. Urging Pacific Island governments to transition to the delivery of effective cervical cancer screening with HPV testing and pre-cancer treatment services.Consideration should be given to self-collection of vaginal samples in order to facilitate scale up and acceptability.

Treatment:

  1. Urging cooperation between Pacific Island Governments to establish a treatment centre for cervical cancer, including radiotherapy, to act as a referral hub within the Pacific.

Workforce:

  1. Assisting Pacific Island governments and training agencies to develop an essential workforce for the delivery of HPV vaccination, cervical cancer screening and the management of cervical cancer.

Registry establishment:

  1. Assisting in establishing an adequate registry to record information about vaccination, screening and treatment for the prevention of cervical cancer; and with potential linkage to a cancer registry. This will facilitate follow-up of the young with incomplete vaccination and women through the screening pathway.  It will also enable robust monitoring and evaluation of vaccination and screening program performance.

END

For more information, please email/call any of the following:

Professor Alec Ekeroma, HOD, Department of Obstetrics and Gynaecology, University of Otago, Wellington, New Zealand. E: alec.ekeroma@otago.ac.nz

Professor Marion Saville, Executive Director, VCS Foundation, Melbourne, Australia. E: msaville@vcs.org.au

Professor Andrew Vallely, Papua New Guinea Institute of Medical Research, Goroka; and The Kirby Institute, UNSW Sydney, Australia. E: avallely@kirby.unsw.edu.au

Dr Steven Badman, Public Health Interventions Research Group, The Kirby Institute, UNSW Sydney, Australia. E: sbadman@kirby.unsw.edu.au

Clinical Associate Professor Deborah Bateson, Medical Director Family Planning NSW, Australia. E: deborahb@fpnsw.org.au

Professor Diana Sarfati, Head of Department, Public Health, University of Otago, Wellington, New Zealand. E: diana.sarfati@otago.ac.nz

 

[1] These two tests should be 10 years apart.  Clinically validated PCR based tests should be used.

 

Papillomavirus Research Special Edition

This special collection consists of a series of reviews summarizing some of the key insights presented and discussed at the 32nd International Papillomavirus Conference (IPVC) and Asia-Oceania Research Organization in Genital Infection and Neoplasia (AOGIN) 2018, which was held in October 2018, in Sydney Australia. The conference was held at a pivotal moment for the International Papillomavirus Society, AOGIN and for HPV research: it came hard on the heels of the announcement by the Director-General of the World Health Organization (WHO) that cervical cancer elimination was within reach and that WHO would focus on the development of a draft strategic plan for elimination.

You can find the special edition here.