2023-09-28 13:02:35
Spain is “relatively close” to the goal of the World Health Organization (WHO) to eliminate cervical cancer as a public health problem, with complete vaccination coverage of 81% and all women diagnosed with the tumor treated. , although there is still “a long way to go.”
The experts Ana Santaballa and Mar Ramírez. PHOTO EFE/David Fernández
They have made it clear the gynecologist oncologist at the San Carlos Clinical Hospital in Madrid Mar Ramírez y the head of the section of breast cancer and gynecological tumors at the La Fe University and Polytechnic Hospital in Valencia, Ana Santaballain a new edition of #EFEDialogues. On this occasion the meeting, in collaboration with MSD, has addressed “the achievements and challenges on the path towards the elimination of cervical cancer.”
According to the WHO, every year in the world they are diagnosed more than 600,000 cases of cervical cancer and half of the patients do not survive.
An unequal global situation
In the specific case of In Spain, the incidence is around seven cases per 100,000 women, with a total of about 2,000 new diagnoses per year.of which 50% do not survive.
This tumor is Caused 99% of the time by the human papillomavirus (HPV)which in some cases the immune system cannot eliminate it and generates a latent infection that progressively damages the epithelium of the cervix and if not treated can lead to cancer.
If it is detected at an early stage, survival exceeds 90%, but if it is in an advanced phase the figure is less than 50%, as Santaballa has pointed out.
The situation is not the same in all countries, in fact, the numbers get worse the fewer resources they have.
Risk factor’s
The risk factors for cervical cancer are those related to the acquisition of the human papillomavirus, details the oncologist from La Fe. Among them, the beginning of sexual relations at an early age, having several sexual partners and having high-quality sexual partners. risk.
Oncologist Ana Santaballa during the meeting. PHOTO EFE/David Fernández.
But non-adherence to screening programs “which are so important” is another of the main factors since the virus is not detected early and latently begins to cause precancerous lesions.
Santaballa also recalled that in those people whose immunity is lower and have contact with the virus, the risk of the infection becoming latent is greater.
“The last risk factor that we must not forget is tobacco,” emphasized the oncologist, who recalled that this can be the trigger for many types of cancer, including cervical cancer.
Ramírez has insisted that the virus is the causal agent, but the usual thing is for the infection to subside, something that happens to 80% of sexually active people.
The 90-70-90 goal
It is a cancer that has a vaccine, which can be prevented and there are also screening programs to detect it early, which is why the WHO set global goals so that by 2030 countries are on track to eliminate it.
This is the 90-70-90 objective, which translates into reaching 90% of girls vaccinated before turning 15 on that date; 70% of women tested for HPV before age 35 and again before age 45; and 90% of diagnosed women treated.
With these percentages at the end of the century, beginning of the next, the incidence of cases would have been reduced by 96% and 62 million deaths from this cause could have been avoided, according to Ramírez, who is also president of the Spanish Association of Cervical Pathology and Colposcopy (AEPCC).
The Spanish panorama
In Spain, the HPV vaccine is incorporated into the vaccination schedule at age 12 for girls and boys (for these it was approved in 2022 and the communities have until 2024 to incorporate it).
Vaccination coverage for girls is very close to 90%, and with the complete schedule it stands at 81%; In addition, more and more adult women are being vaccinated.
Gynecologist Mar Ramírez during the event. EF PHOTO/David Ramírez
Regarding screening programs, they are being carried out in all the autonomous communities and more than 90% of the diagnosed women are receiving treatment and the necessary care.
“We are relatively close to achieving the percentages that the WHO asks of us, but we must continue working,” said Ramírez, who like Santaballa stated that “there is a long way to go.”
The advancement of treatments
There has also been “a lot of progress” in terms of treatments, according to the oncologist at the Hospital de La Fe, because years ago this tumor was “devastating” as there were few therapeutic tools when the disease was in advanced stages.
For about four years now, immunotherapy has been added to chemotherapy, so clinical trials show that both improve survival and to which antiangiogenic agents – which prevent the formation of new blood vessels – can be added.
Both experts have pointed out the importance of patients being treated in centers that have multidisciplinary teams.
The challenges
And among the challenges ahead to eliminate this tumor are, according to experts, continuing with research and raising awareness among the population that cervical cancer can be prevented and eliminated but “you have to work to achieve it,” she said. Ramírez influenced.
Doctors Mar Ramírez and Ana Santaballa together with the director of EFEsalud, Javier Tovar, moderator of the debate. PHOTO EFE/David Fernández.
This cancer can be prevented but “it is not just a thing for women”, which is why Santaballa has called on fathers and mothers to also vaccinate their male children.
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