Cervical cancer
The exceedingly low uptake of high-risk human papillomavirus (HPV) vaccine constitutes a critical gap in Pakistan's public health strategy. Cervical cancer, primarily caused by HPV infections, is one of the most preventable yet deadly cancers affecting women globally. According to the International Agency for Research on Cancer (IARC), cervical cancer is the fourth most common cancer among women, with 604,000 new cases and 342,000 deaths reported worldwide in 2020.
In contrast, many Western nations have made impressive strides in combating this disease. Data from Australia's National HPV Vaccination Programme show that robust vaccination efforts have led to a reduction of over 70% in HPV infections among vaccinated cohorts. These countries have embraced the WHO guidelines, which recommend routine HPV vaccination for girls aged 9 to 14 years. Specifically, the WHO advises a two-dose schedule for those vaccinated before their 15th birthday and a three-dose schedule for older recipients. Furthermore, the vaccine is over 90% effective in preventing infections with HPV types 16 and 18 — the strains responsible for nearly 70% of cervical cancer cases.
Regrettably, Pakistan lags significantly behind, with HPV vaccination coverage estimated to be below 5%. Local estimates further suggest an age-standardised incidence rate for cervical cancer ranging between 6.0 and 10.0 per 100,000 women, although these figures are likely underreported due to limited screening programmes.
Policymakers, health authorities and community leaders must integrate HPV vaccination into our national immunisation programme. Through improved vaccine coverage and comprehensive public education, we can significantly reduce the future burden of cervical cancer and safeguard the health of our women.
Saba Ali Nawaz
Islamabad
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