Eradicating cervical cancer throughout Ireland is a realistic and achievable goal, argues Henrietta Campbell
The findings of last week's study, published in the respected international medical journal, Lancet Oncology, which shows that survival rates for female cancer patients in Ireland are below the European average, should come as a wake-up call for the Government and the Health Service Executive (HSE).
The study is the largest international project to compare survival of patients and it is the first to directly compare cancer survival in Ireland with other European countries.
Figures for cancer survival in Ireland were shown to be considerably lower than the higher-performing northern European countries studied. Of all the cancers that affect women in the Republic, the relatively high mortality rates associated with cervical cancer are particularly unacceptable.
Each year, 70 women in the Republic die from cervical cancer and 180 new cases are diagnosed. Each day, more than 60 women receive an abnormal smear result from their GP.
In recent years, the incidence of cervical cancer has been rising steadily in Ireland, while in all other comparable countries it has been falling significantly. The failure to introduce a comprehensive, population-based cervical screening programme has led to this differential and has been the cause of too many unnecessary deaths.
Cervical screening programmes have been in place in the UK for two decades and have been shown to save lives. Every effort must now be made to ensure that the screening programme is rolled out as promised across Ireland.
Cervical cancer is caused by infection with the human papilloma virus (HPV), with up to 80 per cent of women experiencing HPV infections in their lifetime.
This knowledge has made vaccination a viable option for cervical cancer prevention.
Two pharmaceutical companies, Merck and GSK, have recently produced vaccines against HPV. Trials to date have shown that they provide almost complete protection against the two most common strains of HPV known to cause the disease. The trials have also shown that the vaccines are safe.
The potential to eradicate cervical cancer is therefore emerging as a major public health advance and one that has implications for women worldwide. The development of the vaccine opens up the possibility of effectively ending cervical cancer within a few generations. Many governments have acted promptly to introduce a HPV vaccination programme, including the French, Italian, Spanish, German, Belgian, Austrian, Greek, Norwegian, Canadian and Australian governments, as well as several states in the US.
The UK has recently announced that a vaccination programme will be rolled out in September 2008.
In the recently published Programme for Government, a commitment is given to make a cervical cancer vaccine available as "a universal public health entitlement", once it is recommended by experts.
To make up for the years lost, it is essential that the health authorities in the Republic prioritise the implementation of the vaccination programme, given the proven benefits.
As with the successful introduction of the childhood vaccine against meningitis C, this could be undertaken as an all-Ireland initiative to allow a sharing of resources and expertise, and to ensure faster implementation across the island of Ireland.
Ireland has now been presented with the opportunity to make up for past inaction by putting in place a world-class strategy to eliminate cervical cancer. It can use its late-mover position to its advantage by learning from experience elsewhere to leapfrog into international leadership in this critical area of public health. As with the ban on smoking in public places, commitment and decisive action are needed to ensure that Ireland becomes a leader in this major health issue.
Perhaps more controversially, however, there is also an urgent necessity to address the needs of those women who present with cervical cancer. Minister for Health Mary Harney has published a comprehensive strategy for the improvement of cancer services.
The HSE and the medical profession must ensure that this policy is implemented immediately. Women with cervical cancer need to be able to access high-quality cancer care, delivered through multidisciplinary teams working to national standards of excellence, in dedicated cancer centres.
A prompt decision on the timeframe of the introduction of a national immunisation programme, together with the roll-out of the national screening programme, offers the first realistic opportunity to prevent cervical cancer in current and future generations of women in Ireland.
Until cervical cancer is eliminated, women presenting with this life-threatening disease must have access to high-quality services. To address the inaction of the past, commitment, courage, decisiveness and action are urgently required.
Dr Henrietta Campbell is the chief executive of the All-Ireland Cancer Foundation (AICF), a charity which brings together leaders from business, statutory and voluntary health agencies in Northern Ireland and the Republic to improve the prevention and treatment of cancer