Ireland announced its commitment to the World Health Organization (WHO) global initiative to eliminate cervical cancer, in January 2023. Since then, we’ve been working with other HSE programme and services, the National Cancer Registry of Ireland and a team of experts in Australia to estimate Ireland’s target date for elimination.
This target date will be announced on 17 November 2023 at an event in the Department of Health hosted by the Minister for Health, Stephen Donnelly TD, to mark Cervical Cancer Elimination Day of Action.
A new roadmap will be published plotting Ireland’s next steps to elimination so we can stay on track to achieve and/or maintain the WHO 2030 targets:
- 90% of girls vaccinated against HPV by age 15
- 70% of women screened by age 35 and again by age 45
- 90% of people identified with cervical disease treated
What is elimination?
The WHO defines elimination as fewer than 4 cases per 100,000. Reaching this milestone would make cervical cancer a rare disease. It does not mean zero cases of cervical cancer, but it will bring us to a point where there are so few cases that it is no longer a public health problem.
How do we get there?
Ireland has already shown it is capable of reaching the WHO 2030 targets to put us on course to elimination. There are encouraging indicators of high HPV vaccination, screening and treatment coverage and uptake rates. To reach our goal of eliminating cervical cancer in Ireland, emphasis will be on sustaining these rates and increasing participation in vaccination and screening.
Emerging evidence
There is growing evidence that Ireland is in a strong position to reach elimination.
- The National Cancer Registry Ireland published a report in 2022 showing a steep decline in cervical cancer incidence in Ireland since the introduction of the CervicalCheck programme in 2008 - an average 2.8% reduction annually between 2009 and 2019. The report also shows that cancers detected via screening were found at a substantially earlier stage where for many, the treatment required is much less and survival rates are improved compared to those cancers detected in people with symptoms.
- We recently published new research which provides early evidence of the impact of HPV vaccination on cervical disease in Ireland. The study found a big drop in the percentage of cervical screening tests showing serious precancer disease in vaccinated women aged 25 - early signs of the positive protective effect of HPV vaccination in women at the time of their first cervical screening.
HPV is the cause of most cervical cancers and wider coverage and uptake of the vaccine will reduce cervical cancer incidence further in Ireland. Our research adds to the growing international evidence that a combination of HPV vaccination and screening can lead to cervical cancer elimination.
Leaving no one behind
Improving health equity is a priority to achieve elimination.
- The Laura Brennan HPV vaccine catch-up programme is available free in Ireland and gives young women aged 24 and younger, and young men aged 21 and younger who did not previously receive the vaccine in school an opportunity to get vaccinated.
- The National Screening Service works with communities to reduce inequity in screening and is developing a strategic framework to improve equity, due to be published by the end of 2023.
- We’ve also been doing research exploring the potential role of self-sampling in cervical screening funded by the Women’s Health Taskforce. We’re particularly interested in finding out if self-sampling could benefit women who have never attended cervical screening and those who don’t attend regularly. Findings from the research will be published in due course.
More work is needed to ensure that everyone has the choice and the opportunity to access HPV vaccination, cervical screening and treatment services. We know there are some population groups that are less likely to access these services than others, and it is often these people who could benefit most from it.
We’ll be calling on everyone to get involved in the next steps to elimination to support our work to reduce inequities so that we can reach more people, particularly those in marginalised and disadvantaged communities.
Together towards elimination
Achieving the global targets requires vaccination, screening and treatment services to work together. We’re working in partnership with the National Immunisation Office, the National Cancer Control Programme and the National Cancer Registry Ireland to progress these targets. A wider strategic group is overseeing the work with participation from patient advocates and NGOs.
The focus of our National Cancer Strategy is cancer prevention, finding cancer early and providing access to timely treatment. Cervical cancer is preventable. It could be the first cancer to be eliminated globally. Screening, vaccinations and treatment are key to getting us there, and in Ireland, we have all of these available to us. We’re already saving lives and improving people’s health.
A society-wide effort is now needed to take these next strides with us on the road to elimination, including a high-level political commitment, partnerships with civil society, collaboration with patient and advocacy groups, teamwork with the health and scientific communities, and cooperation and support from media groups.
Together we can go the distance. Together we can make a difference.
Follow us on X @NSShse for updates on the event to mark Cervical Cancer Elimination Day of Action.