Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC H4A 3T2, Canada.
Research Institute of McGill University Health Centre, Montréal, QC H4A 3J1, Canada.
Curr Oncol. 2024 Sep 29;31(10):5850-5861. doi: 10.3390/curroncol31100435.
Cervical cancer is almost entirely preventable and treatable when detected early, making its elimination within reach for Canada and the world. However, cervical cancer is now the fastest-increasing cancer (+3.7% per year since 2015) in Canada as of 2023, marking the first significant increase in cervical cancer incidence since 1984. The human papillomavirus (HPV) vaccine and cervical screening are key preventive measures, with targets set by the WHO and the Canadian Partnership Against Cancer (CPAC) to eliminate cervical cancer in Canada by 2030 and 2040, respectively. These targets include increasing HPV vaccination rates, implementing primary HPV screening, and improving follow-up for abnormal HPV+ results. However, Canada's progress has been impeded by significant challenges. As of the most recent data, HPV vaccine coverage rates in Canada range from 47% to 81%, with an estimated national HPV vaccination completion rate of 64% in Canada, far below the target of 90% by 2025 set by the CPAC. With the exception of British Columbia and Prince Edward Island, the adoption of HPV DNA testing as the primary screening method has been slow across the Canadian provinces and territories despite its superior sensitivity compared with traditional cytology. This article reviews the current state of HPV vaccination and screening in Canada, emphasizing the need for coordinated efforts, transparency, and resource sharing to overcome barriers. Key recommendations include the dissemination of accessible educational materials, partnerships, and collaboration, including nationwide task forces and roundtables, and the implementation of standardized guidelines for HPV screening. Achieving cervical cancer elimination requires a united approach involving federal, provincial, and territorial health authorities, researchers, clinicians, NGOs, community groups, and patients' voices working together to ensure consistent, effective, timely, and meaningful cervical cancer prevention strategies are used across the country.
宫颈癌在早期发现时几乎完全可以预防和治疗，因此加拿大和全世界都有望消除宫颈癌。然而，截至 2023 年，宫颈癌现在是加拿大增长最快的癌症（自 2015 年以来每年增长 3.7%），这标志着自 1984 年以来宫颈癌发病率首次出现显著增长。人乳头瘤病毒（HPV）疫苗和宫颈癌筛查是主要的预防措施，世界卫生组织和加拿大癌症伙伴关系（CPAC）分别设定了目标，即在 2030 年和 2040 年在加拿大消除宫颈癌。这些目标包括提高 HPV 疫苗接种率、实施主要 HPV 筛查以及改善 HPV+异常结果的随访。然而，加拿大在实现这些目标的过程中遇到了重大挑战。根据最新数据，加拿大的 HPV 疫苗接种率在 47%至 81%之间，全国 HPV 疫苗接种完成率估计为 64%，远低于 CPAC 设定的到 2025 年达到 90%的目标。除不列颠哥伦比亚省和爱德华王子岛外，尽管 HPV DNA 检测的敏感性优于传统细胞学，但加拿大各省份和地区仍缓慢采用 HPV DNA 检测作为主要筛查方法。本文综述了加拿大 HPV 疫苗接种和筛查的现状，强调需要协调努力、透明度和资源共享来克服障碍。关键建议包括传播易懂的教育材料、建立伙伴关系和合作，包括全国性的工作队和圆桌会议，以及实施 HPV 筛查的标准化指南。实现消除宫颈癌的目标需要联邦、省和地区卫生当局、研究人员、临床医生、非政府组织、社区团体和患者代表共同努力，确保在全国范围内使用一致、有效、及时和有意义的宫颈癌预防策略。
