Each year around 300 Norwegian women are affected by cervical cancer. Most are in their 30s and 40s. This form of cancer is completely curable. Now scientists believe that it can happen faster than first thought. Researchers at the Norwegian Cancer Registry have published a new report. There they propose comprehensive measures to get rid of the spread of HPV and cervical cancer. – There is a huge epidemic going on and the epicenter is among young people between the ages of twenty and thirty. That’s what Mari Nygård says about the spread of HPV. She is head of the research department at the Cancer Registry. Target in ten years In Norway, 302 people were diagnosed with cervical cancer in 2022. This is a decrease of 50 cases from the previous year. Our neighboring countries have come further in combating HPV and cervical cancer. Among other things, they started earlier by offering vaccines widely in the population. HPV is the main cause of cervical cancer. The World Health Organization has a goal that less than 4 women per 100,000 will get the cancer. Norway will not reach this goal until 2039 with the measures we have today. This is what the researchers write in the report. They themselves believe that we can eradicate cervical cancer by 2033. To achieve this, these measures must be introduced as quickly as possible: Introduce a vaccine that covers most HPV types Give the vaccine widely in the population Expand the screening offer This is proposed as an addition to the measures that have already been introduced . Report on the elimination of HPV and cervical cancer The report has been prepared by researchers Mari Nygård, Ståle Nygård and Thea Falkenthal at the Norwegian Cancer Registry These are the recommendations: Offer a broad-spectrum vaccine that covers most HPV types Free vaccine for all men and women under 30 Free vaccine for particularly vulnerable groups Offer an HPV test to women at the same time as the vaccination offer Women who receive the vaccine are offered to take an HPV test themselves with a so-called home test or self-test, without having to undergo a gynecological examination. The test is sent to a laboratory for HPV analysis Tailored and close follow-up of HPV-positive women All these measures should be introduced as early as 2023, the researchers believe. In addition, we have a program in which women are examined for the early stages of cervical cancer. The researchers also believe that men must be offered a so-called catch-up vaccine. This means that those who were over 12 years of age when the vaccine was introduced will receive an offer. – It is a virus that is spread through sexual contact, so both boys and girls must have protection against the virus, says Mari. Women should also be offered an HPV test at the same time as they are vaccinated. In addition, it should be easier to get access to home tests, the researchers believe. A public health nurse gives the HPV vaccine. The picture was taken on an earlier occasion. Photo: Christina Cantero / news Protects more broadly Today, the vaccine Cervarix is offered in the children’s vaccination programme. It protects against two types of HPV virus, which accounts for 70 percent of cervical cancer cases. In addition, research has shown that Cervarix has cross-protection against three other virus variants. The researchers behind the report believe that the health authorities should rather offer Gardasil9. This is a so-called broad-spectrum vaccine. It protects against 9 different types of HPV virus, which accounts for around 90 percent of cases of cervical cancer. – These types cause half of the pre-stages in cervical cancer that the cervical program detects and treats, says Nygård. Since the increase in the HPV virus in the population has increased drastically, the precursors that Cervarix does not protect against have also increased. This cell test shows HPV-infected cells. The vaccines offered today protect against two types of HPV virus. Photo: Wikimedia Commons Chosen the wrong vaccine It is HPV16 and HPV18 that cause most cancer cases. Cell changes that occur due to other HPV viruses are also treated today – because we lack knowledge and want to be on the safe side, says Nygård. Changing the vaccine will thus be able to prevent overtreatment in the cervical programme, the researchers believe. – Do you therefore mean that we have chosen the wrong vaccine in Norway? – We try not to take into account choices that have been made, but in a perfect world, then yes, says Nygård. Mari Nygård is head of the research department at the Cancer Registry. Photo: The Cancer Registry The Cancer Registry has had a research collaboration with the manufacturer of Gardasil since 2004. – Will it not weaken the trust in the recommendation, that you recommend a vaccine where you collaborate with the manufacturer? – So far we have been careful not to have strong opinions about vaccine selection. Now, however, this vaccine is so well established, and has such good results, that it is not particularly surprising to consider it the best choice, says Nygård. She adds that the Cancer Registry has been open about the collaboration throughout. Disagree with switching vaccines – As we consider it, switching vaccines is not something that will contribute to a faster fight against cervical cancer. That’s what Are Stuwitz Berg, director of the department for infection control and vaccination at the Institute of Public Health (FHI), says. Researchers from FHI, the Norwegian Cancer Registry and the University of Oslo have teamed up on a modeling study. There are findings from this study that indicate that a vaccine change will not have an effect, says Stuwitz Berg. Are Stuwitz Berg is department director for infection control and vaccination at FHI. Photo: Torstein Bøe According to FHI, the two vaccines offered today, Gardasil and Cervarix, are considered equivalent. Cervarix, which is used in the children’s vaccination program, has a high degree of cross-protection against the types of HPV that are related to cancer, adds the department director. The vaccine works best if it is given before the young people become sexually active. Stuwitz Berg says FHI supports several of the proposals in the report. Among other things, they believe that vaccination for vulnerable groups is a good measure, and work is already underway on this. FHI is unsure whether HPV and related cancers can be eradicated earlier than 2039. – It is a bit difficult to say based on the knowledge we have today, says Stuwitz Berg.
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Researchers at the Cancer Registry propose new measures to combat HPV and cervical cancer – news Trøndelag
