“A future without cervical cancer is a battle to be won”

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At this year’s 10th HPV Summit, the “Gains, What’s Next and the Way Forward” were discussed in order to achieve the Ministry of Health’s vision for a cervical cancer-free Philippines by 2040.

It was themed “A Decade of Building an HPV and Cervical Cancer Free Philippines” and was sponsored by the Cervical Cancer Prevention Network of the Philippines (CECAP) in partnership with the Asia & Oceania Federation of Obstetrics and Gynecology (AOFOG), Philippine Obstetrical and Gynecological Society (POGS) and the DOH. Cecilia Llave, Chairwoman of CECAP, and Dr. Ingrid Magnata, Country Manager at Jhpiego, discussed the 2020-2030 acceleration plan for a world without cervical cancer. To achieve the goal of less than 4 cases of cervical cancer per 100,000 women by 2030 or a 30 percent reduction in mortality from the disease, a holistic approach is essential, of HPV vaccination, screening and treatment of pre-invasive diseases, treatment of invasive cervical cancer as well as symptom management and palliative care, they said. This goal is also supported by the DOH’s Cancer Supportive Care and Palliative Care Medicines Access Program (CSPMAP). Dr. Magnata found that 9 out of 10 new cases of cervical cancer occur in low-to-middle-income countries (LMIC) where access to vaccination and screening is limited. Human papillomaviruses (HPV) cause most cases of cervical cancer and precancerous lesions of the cervix. Genital HPV is a common virus that is mainly spread through skin-to-skin contact during sexual activity and may not have any visible signs or symptoms. At least 14 types of HPV are considered carcinogenic. These HPV-related cancers and diseases are cervical cancer, vaginal and vulvar cancer, penile cancer, anal cancer, oropharyngeal cancer, and genital warts. Cervical cancer is one of the types of vaccine preventable and treatable, but according to Dr. Rosario Vergeire, State Secretary for Public Health Services of the DOH, it remains the second most common cancer after breast cancer in Filipino women. More than 7,000 new cases of cervical cancer and more than 4,000 deaths from cervical cancer are expected to occur each year. An estimated 11 Filipino women die from cervical cancer every day.

Prof. Kazunori Ochai, President of AOFOG, emphasized that vaccination is still considered one of the most optimal strategies for protection against HPV. He said regular screening is also highly recommended to help identify precancerous lesions caused by types of HPV not covered by current vaccination and to protect unvaccinated women from areas of poor coverage. These include Pap smears or visual acetic acid inspection, as well as precancerous and cervical cancer treatments in a single visit (SVA) approach. An example of an effective vaccination system supported by the collaboration of multiple stakeholders is the DOH’s free HPV vaccination for young girls aged 9-14 as part of the School-Based Immunization (SBI) program. This program has been switched to a community-based vaccination program due to the COVID-19 pandemic. Once classroom teaching resumes, HPV vaccination will revert to the original SBI protocol implementation. Dr. Patrick Tejano, Program Manager of the DOH National Vaccination Program, emphasized the importance of vaccinating early, especially for young women, before they are exposed to HPV. The HPV vaccine can help protect girls from the exposure to cervical cancer later in life, he said. The summit also noted that several health laws currently play a crucial role in implementing the holistic model of cancer care. The first is the Universal Health Care (UHC) Act, which states that every Filipino is entitled to and access to preventive, conducive, curative, rehabilitative, and palliative care for medical, dental, mental, and emergency care. Another law is the National Integrated Cancer Control Act (NICCA), which provides for the prevention and control of cancer by improving the chances of survival by expanding programs such as primary prevention, early detection or screening, prompt and accurate diagnosis, treatment, monitoring, survival care and rehabilitation and hospice care. Dr. Mae Dolendo, a member of the National Integrated Cancer Control Council, discussed the NICCA updates. She said the Philippine Cancer Center (PCC), which will serve as the national cancer specialty center, will open in 2025. The PCC’s management office has already been set up. 24 DOH hospitals are also to be upgraded as special centers for cancer. The PCC is currently conducting a scoping activity to prepare a development plan for the cancer registry. The annual HPV Summit, which began in 2012, is a gathering of health professionals, medical societies, patient groups, advocates, health program officers, policy makers, media, civil society organizations, and the private sector to review key developments and strategies along the way help eradicate HPV-related cancers and disease as a public health problem.

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