A new UW study led by Ruanne Barnabas, Associate Professor, UW Department of Global Health/ International Clinical Research Center (ICRC), aims to shed light on effective strategies for cervical cancer elimination. The study will increase understanding of how a combination of screening and vaccination strategies can be used more effectively to eliminate cervical cancer in low- and middle-income countries (LMICs).
Through an award from the World Health Organization (WHO), the study will use mathematical models to evaluate the impact of vaccination and screening in South Africa and Kenya, while accounting for HPV-HIV interactions.
“Given that women living with HIV have two to five times higher risk for cervical cancer, it is critical to understand the impact of current strategies for cervical cancer elimination among this population,” says Barnabas. “There are many promising interventions, but what combination of strategies are needed to effectively and efficiently eliminate cervical cancer in LMICs? This study will help reveal what else is needed – who needs to be screened, when they need to be screened, and more.”
The study is part of WHO’s 2019 Global Strategy towards the Elimination of Cervical Cancer. “It’s exciting to be part of a large consortium of researchers from all over the world working together on the WHO Investment Case for cervical cancer elimination,” says Barnabas.
The study findings will feed into the WHO Global Strategy, helping to inform how cervical cancer prevention interventions should be scaled up. The findings will estimate the impact of scale-up of vaccination and screening on cervical cancer outcomes in populations where HIV prevalence is high, helping to address disparities in cervical cancer incidence in women living with HIV.
Cervical cancer affects over half a million women each year, and kills a quarter of a million. One woman dies of cervical cancer every two minutes, making it one of the greatest threats to women’s health. Nearly 90% of those deaths are in LMICs. Although HPV vaccination is vital to preventing cervical cancer, research shows that vaccination alone is insufficient. Currently efforts to control cervical cancer incidence are limited by low coverage of screening programs, limited coverage of HPV vaccination, and a high burden of HIV infection. To achieve elimination, intensive vaccination, screening, and treatment must be pursued in combination.
The UW Cervical Cancer Elimination Modeling Team led by Barnabas includes Darcy Rao, Cara Bayer, and Gui Liu. The study builds on the UW Department of Global Health/ICRC’s long track record of HIV and HPV modeling, cost-effectiveness analyses, and deep and long-standing collaborations with partners in sub-Saharan Africa.
The one-year project’s specific aims are to: Estimate, using HPV-HIV transmission models, the impact of vaccination alone on cervical cancer incidence in a high HIV prevalence setting; Evaluate, using dynamic HPV-HIV models, the impact of a once in a lifetime screen in addition to vaccination on cervical cancer incidence in a high HIV prevalence setting; and Determine, using dynamic HPV-HIV models, the optimal age for a once in a lifetime cervical cancer screen in addition to HPV vaccination, in a high HIV prevalence setting.
For more information on ICRC, see https://www.washington.edu/research/research-centers/international-clinical-research-center-icrc/