With significant global attention currently focused on how to deal with COVID-19, other health concerns have taken a backseat due to financial issues and fears of contracting the virus during health check-ups. According to Jo’s Cervical Cancer Trust, the United Kingdom’s leading cervical charity, which surveyed 851 women between 29 May and 9 June, 25% were worried about the risk of contracting COVID-19 if they went to a cervical cancer screening appointment.
In the Philippines, cervical cancer ranks second among the leading prevalent types of cancer among women. To defer essential screening and preemptive health actions in high-burden settings is not advisable. It may lead to an increase in the incidence of morbidity and mortality among women by an otherwise preventable and treatable disease.
Hence, this year’s 9th HPV Summit led by the Cervical Cancer Prevention Network of the Philippines in partnership with the Asia & Oceania Federation of Obstetrics and Gynaecology, Philippine Obstetrical and Gynecological Society, and the Department of Health aims to highlight the importance of continuously pursuing the global strategy to eliminate cervical cancer despite the current coronavirus pandemic. The momentum gained from previous efforts must be maintained to achieve the DOH’s thrust for a cervical cancer-free Philippines by 2040.
HPV stands for human papillomavirus. Genital HPV is a common virus spread mainly by skin-to-skin contact during sexual activity which may have no visible signs or symptoms. The body clears the infection on its own in most people, but can sometimes cause serious illness3. At least 14 types of HPV have been found to be cancer-causing. These HPV-related cancers and diseases are cervical cancer, vaginal and vulvar cancers, penile cancer, anal cancer, oropharyngeal cancer, and genital warts.
The incidence of cervical cancer in Asia Oceania countries varies from the lowest in Australia with age standardized rate (ASR) of 4.9 per 100,000 women to the higher ranges of 27 and 27.4 in India and Cambodia, respectively, to 28 in Mongolia, and 32 per 100,000 women in Nepal5.
In the Philippines, cervical cancer is the 2nd most frequent cancer among Filipino women between 15 and 44 years of age. According to the 2015 Philippine Cancer Facts and Estimates, there is an annual age standardized incidence of cervical cancer of 16/100,000 and mortality rate of 7.5 per 100,000. (Ref: Clinical Practice Guidelines by SGOP, July 2019)
HPV-related cancers such as cervical cancer can be prevented and treated if detected at its early stages6. The precancerous stage provides ample window for detection and treatment, and it could take as long as 30 years before it reaches malignancy4. However, it is one of the most common types of cancer and common causes of cancer-related deaths worldwide, affecting mostly young, vulnerable women from poor countries7.
The purpose of the HPV Summit is to provide an overview of the current situation of HPV-related cancers and diseases and its control and prevention in various Asia Oceania countries: their views of an ideal program, identified obstacles, and suggestions to overcome them are discussed.
Dubbed as “HPV-Free LEAD,” the Summit is composed of four (4) virtual sessions which will delve on the following themes: Leveraging on Asia Oceania commitment for cervical cancer elimination; Empowered by Science: Innovative ways towards HPV-free Asia Oceania; Advancing healthcare policy for HPV-free Asia Oceania; and Directing concerted actions towards an HPV-free and Cervical cancer-free Asia Oceania.
To achieve the goal of less than 4 cases per 100,00 women by 2040, a holistic approach is vital and this includes HPV vaccination, screening and treatment of pre-invasive disease, treatment of invasive cervical cancer, and symptom management and palliative care.
Vaccination is considered one of the most optimal strategies in guarding against HPV8. Regular screening is also recommended from aged 30 and regularly afterwards to detect pre-cancerous lesions and cancer caused by types of HPV not covered by present vaccination for women who may have no symptoms, and also to allow early detection for non-vaccinated women from areas where vaccination coverage is low7. This includes pap smear or visual inspection with acetic acid, and treatments for pre-cancerous lesions and cervical cancer in a single-visit approach.
In 2018, the World Health Organization made a global call for action on cervical cancer elimination. A draft global strategy was created which outlined a list of targets by 2030 and anchored on the three main pillars of prevent, screen, and treat.
The Philippines answered the call by outlining its own roadmap and strategies which shall be achieved through multisectoral partnerships and to be supported by healthcare legislations such as the Universal Health Care Act (RA No. 11223) and National Integrated Cancer Control Act (RA No. 11215). Medical societies in the country joined multiple stakeholders across Asia Oceania in pledging their commitment to achieve worldwide health goals during the AOFOG Manila Declaration: A Call to Action Against Cervical Cancer event held last year.