Canada acts to meet WHO Call to eliminate cervical cancer

TORONTO (February 4, 2020) – Today is World Cancer Day and the Canadian Partnership Against Cancer (the Partnership) is calling on partners in health care and communities across Canada to end cervical cancer in Canada by 2040. The Partnership is leading the development and implementation of a Canadian plan to achieve the World Health Organization (WHO)’s elimination goal in this country. The plan is to reach full HPV vaccination of boys and girls; to move to primary HPV testing plus offer self-sampling in cervical screening programs; and to ensure rigorous follow up when abnormalities are identified. This will advance women’s health and lead to the elimination of cervical cancer in Canada by 2040.

First Nations, Inuit and Métis women continue to experience poorer cervical cancer outcomes than other women in Canada with some women experiencing a three times higher incidence of cervical cancer compared to non-Indigenous women, and a four times higher death rate from the disease.^1,2 Supporting equity is an important consideration to address barriers in accessing care, which includes access to culturally appropriate care. The geographic barriers experienced by many First Nations, Inuit and Métis women are also experienced by underserviced rural and remote communities in Canada who, according to the Canadian Cancer Registry, experience a higher incidence of cervical cancer than urban areas.

The final action plan will accelerate Canada’s efforts to strengthen the core components of cervical cancer prevention, screening and treatment with a significant focus on closing the gaps in care and improving outcomes for First Nations, Inuit and Métis women with cervical cancer.

Read more about the urgent need to collaborate with First Nations, Inuit and Métis and underserviced communities to improve experiences and outcomes in cervical cancer in today’s Globe and Mail.

The action plan will achieve key priorities of the Canadian Strategy for Cancer Control 2019-2029, stewarded by the Partnership. The Elimination of Cervical Cancer Action Plan is an early example of how the Strategy’s priorities can be met ensuring equitable access to high quality cancer care for all people in Canada that will decrease the risk of people getting cancer; diagnose cancer faster, accurately and at an earlier stage; provide culturally appropriate care closer to home; and provide Peoples-specific, self-determined cancer care.

The Partnership is hosting the Elimination of Cervical Cancer Summit today in Toronto. The event brings together provincial and territorial governments, national and international experts, cancer agencies, First Nations, Inuit and Métis leaders, public health agencies, healthcare professionals, women’s health advocacy groups and patients to review the draft action plan. The Summit will identify how to tangibly realize the action plan to eliminate cervical cancer in Canada by 2040.

Cervical cancer in Canada

Each year in Canada, more than 1,300 women are diagnosed with cervical cancer and over 400 die from the disease.³ Almost all cases of cervical cancer are caused by the human papillomavirus (HPV), which is preventable through the HPV vaccine. The publicly funded vaccine is provided to male and female students in every province and territory through school-based programs.⁴ Regular screening of adult women is also vital as cervical cancer caught at an earlier stage has a high survival rate.⁵

By 2040, with an action plan that sets the following targets and achieves them, Canada will reach the WHO’s cervical cancer elimination goal:

• Immunization: By 2025, 90 per cent of students are fully vaccinated with the HPV vaccine by age 17.
• Screening: By 2030, 90 per cent of eligible individuals have been screened with an HPV test; 90 per cent of eligible individuals are up to date with cervical screening; and no less than 80 per cent of eligible individuals in any identifiable group are up-to-date with cervical screening.
• Follow-up: By 2030, 90 per cent of individuals with a positive HPV test should have a clear plan of appropriate follow-up designed and communicated to them within three months of the test that generated the positive result; 90 per cent of all individuals identified as being at elevated risk for significant cervical abnormalities have colposcopy in a timely manner; and no less than 90 per cent of individuals in any identifiable group receive follow-up.

To learn more about the Canadian Partnership Against Cancer and the initiative to eliminate cervical cancer in Canada, visit partnershipagainstcancer.ca/cervical.

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Quotes

Dr. Heather Bryant, MD, PhD, Chair of the Elimination of Cervical Cancer in Canada Advisory Committee and Senior Scientific Lead of Population Health at the Canadian Partnership Against Cancer

“We need to accelerate our work in how we manage cervical cancer prevention and care in Canada. Today’s Summit brings together the key players in the health system, public health, women’s health and international experts to better understand our roles and responsibilities over the next 20 years to reach the goal of eliminating cervical cancer by 2040.”

Elizabeth Holmes, MPH, Manager, Health Policy at the Canadian Cancer Society

“We know that cervical cancer is the most preventable cancer in Canada with nearly all cervical cancer cases being due to HPV. In fact, the Canadian Cancer Society-funded Canadian Population Attributable Risk of Cancer (ComPARe) study found that we could prevent about 5,300 cervical cancer cases by 2042 if more Canadian children were vaccinated against HPV. Today we are presented with a unique opportunity to collaborate, and we know that by working together and focusing on the promotion of HPV vaccination and supporting cervical cancer screening programs, participants in today’s summit can help to reduce the number of future cervical cancer cases in Canada.”

Dr. Eshwar Kumar, Board Chair, Canadian Association of Provincial Cancer Agencies (CAPCA)

“Cancer agencies and programs across the country are continuously looking to improve access to, and increase participation in, cervical cancer screening and prevention programs that they oversee. We look forward to helping to develop and implement an Action Plan for the Elimination of Cervical Cancer in Canada. We are excited to work with all our health system partners to make Canada a global leader in eliminating cervical cancer by 2040.”

Anne Pham-Huy, MD, Chair, Immunize Canada

“Cervical cancer was the second most common cancer in Canadian women after breast cancer, but routine HPV immunization and screening programs have greatly contributed to the decline in incidence of this disease. Canada can be among the first countries in the world to eliminate cervical cancer by 2040 with the Canadian Strategy for Cancer Control. To eliminate cervical cancer, we need to improve HPV vaccination coverage among Canadian children by age 17. HPV immunization is a safe and effective public health measure for reducing the spread of HPV, and one of the best things we can do for women’s health is to boost immunization rates to ensure the next generation of Canadian women are cervical cancer-free.”

Clover Hemans, BScN, MD, MScQIPS, CCFP, FCFPC, President, Federation of Medical Women of Canada and Vivien Brown, MDCM, CCFP, FCFP, NCMP, Chair, HPV Prevention Week and Prevention & Awareness Program, Federation of Medical Women of Canada

“The Federation of Medical Women of Canada is a proud partner of the Canadian Partnership Against Cancer and has heeded the call to help Canada engage in a path to eliminate cervical cancer by 2040.  We are happy to participate in Elimination of Cervical Cancer Summit. This will be an important day to identify how we can all work together on the implementation of the Action Plan for the Elimination of Cervical Cancer in Canada.  Since 2017, the FMWC has led HPV Prevention Week to raise awareness amongst Canadians and policymakers of HPV-related cancers and the benefits of vaccination against HPV. We will continue our efforts and look forward to working with the broader partnership to achieve the goal of eliminating cervical cancer by 2040.”

Dr. Marc Steben, Co-President, HPV Awareness

“For Canada to achieve 90% vaccination, 90% screening and 90% treatment, a firm government commitment and overt endorsement in concert with non for profit organizations (NGO’s), and public and private sector stakeholders will be imperative. To reach the WHO’s objective of cervical cancer elimination, messaging around the elimination of cervical cancer needs to be clear, cohesive and tailored. Further to this, databases linking vaccine and screening, and invitation letters for screening, as well as a rapid investment in a Canada-wide HPV testing capacity will be critical. We have the science and we have the tools, including strategies for communities and involvement of advocacy organizations such as HPV Awareness.  We need commitments from all stakeholders now!”

Public Health Physicians of Canada Executive

“Robust immunization and screening programs are important public health interventions. National and international goals, such as the targets set by the WHO’s call to action to eliminate cervical cancer by 2040, can help us rapidly improve cervical cancer prevention, screening and treatment. We are excited by this work, including the role of HPV vaccination in preventing cancer. We will not achieve these goals however without considering the inequities in our system and adopting concerted efforts to work with underserved populations in Canada. The Public Health Physicians of Canada strongly supports the action plan to eliminate cervical cancer and its priority to increase the equity of cancer care in Canada.”

About World Cancer Day

World Cancer Day takes place every year on February 4 and is the single initiative that allows the world to unite to raise the profile of cancer in a positive and inspiring way. Coordinated by Union for International Cancer Control, World Cancer Day is this year taking place under the tagline “I Am and I Will” and celebrates the power of individual action to reduce the global burden of cancer. It is a chance to reflect on what you can do, pledge your support, and take action against cancer.

This year, World Cancer Day will be recognized across Canada with the following landmarks lit in orange and blue on February 4, 2020:

• Calgary Tower, Calgary, Alberta
• Canada Place Sails of Light, Vancouver, British Columbia
• CN Tower, Toronto, Ontario
• Confederation Building, St. John’s, Newfoundland and Labrador
• Halifax City Hall, Halifax, Nova Scotia
• High Level Bridge, Edmonton, Alberta
• Niagara Falls, Niagara Falls, Ontario
• RCMP Heritage Centre, Regina, Saskatchewan
• The Forks Winnipeg Sign, Winnipeg, Manitoba
• Vancouver Convention Centre, Vancouver, British Columbia

About the World Health Organization Call for Elimination of Cervical Cancer

In May 2018, the World Health Organization (WHO) announced its global call to action towards eliminating cervical cancer based upon the political will to make elimination a reality. Calling stakeholders to collaborate toward reaching this goal, the WHO developed a global strategy to accelerate cervical cancer elimination, setting targets for the period of 2020-2030 which will help countries eliminate cervical cancer. In May 2020, a draft strategy for the elimination of cervical cancer as a public health problem will be shared for the World Health Assembly’s approval, outlining the threshold that cervical cancer will have been eliminated as a public health problem when all countries reach an incidence rate of less than four cases per 100,000 women.⁶

About the Canadian Partnership Against Cancer

As the steward of the Canadian Strategy for Cancer Control (the Strategy), the Partnership works with Canada’s cancer community to ensure fewer people get cancer, more people survive cancer and those living with the disease have a better quality of life. This work is guided by the Strategy, which was refreshed in 2019, to drive measurable change for all Canadians affected by cancer from 2019 to 2029. The Strategy’s eight priorities will tackle the most pressing challenges and include three Peoples-specific and self determined priorities and actions for First Nations, Inuit and Métis, which are represented for the first time in the Strategy, reflecting Canada’s commitment to reconciliation. The Partnership will drive forward the priorities collaboratively with organizations and individuals on the front lines of cancer care – the provinces and territories, health-care professionals, people living with cancer, those who care for them, First Nations, Inuit and Métis governments, organizations and communities, and its funder Health Canada. Learn more about the Partnership and the refreshed Strategy at www.cancerstrategy.ca.

For further information, please contact:

Nick Williams, Communications Officer, Media Relations, Canadian Partnership Against Cancer

416-915-9222, x5799 (office); 647-388-9647 (mobile), nick.williams@partnershipagainstcancer.ca

References
1- Current Oncology. Disparity in cancer prevention and screening in aboriginal populations: recommendations for action. 2015. Available at https://current-oncology.com/index.php/oncology/article/view/2599/1985. Accessed on January 14, 2020.
2- Cancer Care Ontario. Cancer in First Nations People in Ontario: Introduction and Overview. 2017. Available at: https://www.cancercareontario.ca/sites/ccocancercare/files/assets/CancerFirstNationsReport_Accessible.pdf Accessed on January 14, 2020.
3- Public Health Agency of Canada. Cervical cancer. Available at https://www.canada.ca/en/public-health/services/chronic-diseases/cancer/cervical-cancer.html. Accessed on January 14, 2020.
4- Government of Canada. Human papillomavirus (HPV). Available at: https://www.canada.ca/en/public-health/services/diseases/human-papillomavirus-hpv.html. Accessed on January 14, 2020.
5- Canadian Cancer Society. Survival statistics for cervical cancer. Available at: https://www.cancer.ca/en/cancer-information/cancer-type/cervical/prognosis-and-survival/survival-statistics/?region=on Assessed on January 14, 2020.
6- World Health Organization. Cervical cancer – Eliminating cervical cancer. Available at https://www.who.int/health-topics/cervical-cancer#tab=tab_2. Accessed on January 14, 2020.