By Susan Donlon, NSS Communications
Ireland is one of the first countries in the world to publicly declare a commitment to a global initiative to eliminate cervical cancer.
Marking Cervical Cancer Prevention Week 2023 (23 to 29 January), a roadmap has been published setting Ireland on a path to reach global targets set by the World Health Organisation (WHO) – a collaboration of the HSE’s National Screening Service, the National Immunisation Office and the National Cancer Control Programme.
In a press release the Minister for Health, Stephen Donnelly TD said it’s “a truly significant initiative in women’s health” and that Ireland is “in a strong position” to reach the targets.
What does elimination mean?
The current rate of cervical cancer in Ireland is around 11 cases per 100,000 people. The WHO defines elimination as fewer than 4 cases per 100,000. Reaching this milestone would make cervical cancer a rare disease and bring us to a point where there are so few cases that it is no longer a public health problem.
What are the targets?
Known as the 90-70-90 targets, the WHO says every country should reach these by 2030 to put the world on course to elimination:
- 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
Are the targets achievable?
In Ireland, we have all the tools we need to prevent and/or reduce the burden of the disease and to achieve the global targets of timely HPV vaccination, regular HPV cervical screening, and early detection and treatment for those who need it. The type of vaccine, screening test and cervical cancer treatments offered in Ireland are the highest quality available internationally, and importantly, all of these services are free of charge through the health service. This places Ireland in a position to be able to reach the targets set out for elimination.
This short video with Dr Sarah Fitzgibbon, a Primary Care Clinical Advisor with CervicalCheck, explains more about how cervical cancer elimination is possible in Ireland.
How do we get there?
We’re currently working with an international team of experts in Australia to estimate Ireland’s target date for elimination. This will be announced before the end of the year. Once Ireland’s elimination date is established, an action plan will be developed to increase and improve uptake in the vaccination and screening programmes.
Achieving the targets requires vaccination, screening and treatment services to work together, including collaboration with patient advocates and relevant NGOs. This is already happening with the establishment of a Cervical Cancer Elimination Partnership in 2021.
As a population health screening service, the CervicalCheck programme requires eligible people to take part. Speaking with Newstalk Breakfast to mark Cervical Cancer Prevention Week, Dr Sarah Fitzgibbon explains what people need to do to participate and encourages anyone eligible to do so.
Work is required to understand why some people do not access screening services regularly. Of the 300 cases of cervical cancer diagnoses in Ireland annually, around 40% of those occur in women who have never been screened. Meanwhile, some 80% of women who had cervical cancer detected at screening had their cancer detected at the earliest possible stage, allowing for timely treatment. In an interview with The Echo (Cork) Newspaper (24 January 2023) Prof Nóirín Russell, Director of CervicalCheck said that “While we are happy with the attendance levels, we will be working this year on that other 20% and to better understand and address the barriers that might be there for those who don’t attend.”
Work is ongoing on a variety of projects at the National Screening Service to improve access to services and improve outcomes for people who use these services.
How can the elimination initiative be supported?
There are several ways to support Ireland’s efforts to eliminate cervical cancer. Everyone can play a part and thousands of people are already doing so.
- Parents, their children and young people are playing a significant role in reaching global targets by participating in the HPV vaccination programme. Anyone aged 16 to 25 years who missed out on the vaccine in secondary school can now avail of it through the Laura Brennan catch-up programme. Check the criteria here.
- Every eligible person (women and people with a cervix aged 25 to 65) can check the register online to find out when their next screening is due and to ensure that current address and contact details are correct to receive invitations to screening, reminders and results. When screening is due, make an appointment with a GP, clinic or any registered provider.
- Listen to this Real Health podcast with Karl Henry and Dr Sarah Fitzgibbon chatting about everything you need to know about preventing cervical cancer, from screenings to symptoms and HPV vaccinations. Share it with family, friends and colleagues.
- Support the #GetInformed campaign online which aims to ensure that all people eligible for screening and vaccinations are informed about the availability of these services and are empowered to use them.
- Health and social care workers can support people to make informed decisions about accessing screening and vaccinations:
- Complete this short eLearning Course and learn more about the National Screening Service programmes – visit HSELand.ie and search for the course 'Reducing cancer risk: Population-Based Cancer Screening Programmes'. This 20-minute overview will provide you with the knowledge to encourage and support people to consider the benefits of participating in screening.
- Refer people to trusted sources of information - CervicalCheck.ie and HPV.ie.
- Order free resources (posters and leaflets) for your practice, clinic or service at HealthPromotion.ie
Cervical cancer could be the first cancer ever to be eliminated globally. Screening, vaccinations and treatment are key to getting us there. In Ireland, we have all the tools we need. Now more than ever, as we drive towards elimination, let’s each play a part with ensuring that everyone who is eligible benefits from these vital services.
As WHO Regional Director for Europe, Dr Hans Henri P. Kluge remarked in support of the publication of Ireland’s roadmap to elimination: “A cervical cancer-free future is within our grasp. We look to Ireland as a trailblazer in achieving this ambitious goal.”