By Tan Ee Lyn
HONG KONG (Reuters) - Cervical cancer is much more common in Asia than the quarter of a million new cases recorded each year, according to an expert, who says governments should consider vaccinating all women because screenings are too costly.
Margaret Stanley, professor of epithelial biology at Cambridge University, said Asia recorded around half of the world’s 500,000 new cases each year, but women in swathes of the continent lacked access to proper medical services.
“Not all cancers will be registered and you are probably underestimating by 40 to 50 percent,” Stanley said.
After breast cancer, cervical cancer is the second most common cancer among women worldwide. It is caused by several types of the human papillomavirus (HPV), that is spread through sexual contact.
Most women’s bodies are able to fight HPV infection, but it can result in cancer later on. Risks are higher for smokers, mothers of many children, women who have used birth control pills for a long time, or those who are HIV-positive.
While figures have fallen in advanced Western nations after Pap smear screenings and HPV vaccines were made widely available, the situation in Asia has stayed relatively unchanged over the past 50 years. Screenings enable early detection of the disease.
“Particularly in rural areas, these figures have not changed because conditions and factors that contribute to the disease have not changed compared to urban life in a developed country,” Stanley said in an interview.
“It is very much caused by infection of the HPV, and women acquire that when they marry. It’s a sexually transmitted infection associated very much with early marriage, early childbearing, many children, lack of access to medical services.” Half of the incidence of cervical cancer results in death, with most of those cases occurring in developing countries.
The disease strikes mostly between the ages of 35 and 65, when victims are in the prime of their lives as wives, mothers and career women.
“It’s important economically because it literally removes the lynchpin of the family, the wife and mother,” Stanley said. She said the ideal intervention would be vaccination and it could be carried out using a system that is already in place in Asia, where most children are protected from a range of diseases such as measles, mumps, rubella, tuberculosis and polio.
In the case of HPV vaccines, it is generally considered to be best administered between the ages of 9 and 13 years, before girls become sexually active and potentially exposed to HPV.
“Vaccination is extremely well done in Asia. Between 85 and 90 percent of children even in the poorest of countries in Asia are covered. There is a well-established infrastructure for the delivery of vaccine. The challenge is to deliver the vaccine to 11-or 12-year-old girls,” Stanley said.
“There is not an extensive screening program in virtually any country in Asia. The screening programs are not well organized and they are very expensive.”
