Each year, 3,000 women are diagnosed with cervical cancer, a disease almost always caused by a sexually transmitted human papillomavirus (HPV) infection. However, for the World Health Organization (WHO), this cancer, which kills 1,100 women each year, could be totally eliminated thanks to two effective and complementary interventions: screening and vaccination.
On the occasion of European Week for the Prevention of Cervical Cancer, Public Health France and the National Cancer Institute estimate, Saturday, January 29, that these two devices are progressing, but are still insufficient: About 80% of women will be exposed to these papillomaviruses during their lifetime. Extremely common, the infection is mild in most cases. Screening aims to detect pre-cancerous lesions and treat them before they develop into cancer and also makes it possible to detect and treat cancers at an early stage. The European Union recommends screening at least 70% of women.
In France, the screening coverage rate varies greatly according to age and place of residence. It reaches 65% between the ages of 25 and 45 and then decreases to fall to 45% among women aged 60-65. In some departments (such as Seine-Saint-Denis, Val-d’Oise and Val-de-Marne, in the Paris suburbs), screening remains below 50%.
“Until 2018, except in a few departments, there was no organized screening program”, recalls Françoise Hamers, epidemiologist doctor at Public Health France in the cancer unit. Despite a national follow-up campaign by mail and the full payment of the test, without advance payment, only 59% of women aged 25-65 were screened over the period 2018-2020, compared to 58% in 2017-2019.
This screening must be carried out within the recommended time intervals: every 3 years between the ages of 25 and 29 (after 2 tests carried out 1 year apart and the results of which are normal) and every 5 years between the ages of 30 and 65.
Vaccination, available since the 2000s against human papillomavirus infections, is almost 100% effective if injected before the start of sexual life. According to Françoise Hamers, “vaccination coverage remains very low in France”. In 2020, it was estimated at 41% for one dose at age 15 (35% in 2019) and 33% for the full regimen at age 16 (28% in 2019). In France, the vaccine is not fully reimbursed and there is no organized HPV vaccination program, as in Portugal, Sweden or the United Kingdom.
According to a study published by The Lancet, a marked reduction in cases of cervical cancer was observed among women eligible for the British vaccination campaign, launched in 2008. Among women likely to have been vaccinated early, at 12 or 13 years, Cervical cancers have virtually disappeared. Several countries have also extended vaccination to boys, both to protect them from certain cancers and to limit transmission to girls. This is the case for France in 2021.