In Europe, cancer causes one in four deaths. An estimated 13% of the 2.7 million cancer diagnoses can be attributed to cancer-causing infections. Some of these illnesses can be prevented through vaccination.
Vaccines against human papillomavirus (HPV) and hepatitis B (HBV) can protect against a range of cancers. HPV causes cervical cancer and is associated with anogenital cancers, head and neck cancer and genital warts.
Efforts to protect more people against these vaccine-preventable diseases are increasing in the EU and in the wider European Region. The WHO says 38 of the 53 countries in the European region now offer HPV vaccination, although many provide the vaccine to girls only.
In 2022, Albania, Kyrgyzstan, Montenegro and Serbia launched nationwide HPV vaccination campaigns All four have relatively high rates of cervical cancer, with Montenegro having the highest in the region (26.2 per 100,000 women).
Vaccinating 90% of girls against HPV is a key component of a three-pronged plan to eliminate cervical cancer as a public health problem. The other two elements are screening 70% of women aged 35 to 45 for HPV, and treating 90% of patients with the disease.
‘We will continue our support to countries in setting themselves on a pathway to eliminate cervical cancer as a public health problem through universal and equitable HPV vaccination, appropriate cervical cancer screening, timely diagnosis, and quality treatment and palliative care for all women,’ said Dr Nino Berdzuli, Director of the Division of Country Health Programmes at WHO/Europe.
What is the EU doing?
Europe’s Beating Cancer Plan, a flagship EU policy, makes cervical cancer a priority. An EU Joint Action on HPV Vaccination was launched last February (2022) to boost awareness and uptake of immunisation. It builds on the WHO elimination targets, with HPV vaccination for boys as an additional goal.
While national governments are responsible for delivering on the goals of the Joint Action, €5 million in EU funding has been earmarked to support health authorities and non-governmental organisations, and the European Commission is currently accepting feedback on how to improve uptake of HPV and HBV vaccines.
Read the European Cancer Organisation’s HPV Testimonies by people affected by the virus
The Protect-Europe project, a two-year initiative led by the European Cancer Organisation with 33 partners in 16 countries, is expected to develop best practice guidelines on clinical practice and public health communication. Funded by the EU4Health scheme, it launched in Brussels in late January.
‘HPV exposure results in cancers that are now preventable by vaccination, and often treatable if detected early,’ said Prof Daniel Kelly, Founder and Co-Chair, HPV Action Network, European Cancer Organisation. ‘However, this requires public health systems to respond to the challenge by providing protection, via vaccination, to all European citizens as required in the Beating Cancer plan.’
Prof Kelly, who is also a Member of the European Oncology Nursing Society, said the Protect-Europe initiative would share evidence about HPV vaccination through education and engagement with citizens and professionals. ‘Vaccination of girls and boys offers the best way to protect future generations, but all countries now must act to make this goal a reality,’ he told Vaccines Today.
What about liver cancer?
HBV can cause liver cancer ‒ a disease responsible for 60,000 deaths per year in Europe. There is a vaccine against HBV which helps to protect against infection, but it is not available to all who could benefit from protection.
According to the European Liver Patients Association (ELPA), only 11 countries in Europe have met the WHO goal of 95% HBV vaccination coverage. One third of EU/EEA countries currently have no action plan for combating hepatitis B.
Marko Korenjak, President of the European Liver Patients Association (ELPA) said well-implemented childhood programmes with good coverage, and vaccination programmes targeting key risk groups, can ‘further reduce transmission, prevent the disease burden from growing further, save lives, and reduce the burden of cancer caused by HBV infection on health systems’.
‘In addition, hepatitis D should not be disregarded. The combination of HDV and HBV infection is considered the most severe form of chronic viral hepatitis,’ he told Vaccines Today. ‘Without treatment, the risk of developing advanced liver disease, cirrhosis and liver cancer is significantly high.’ While there is no vaccine to directly protect against HDV, vaccination against HBV indirectly prevents HDV infection and its serious consequences.
Mr Korenjak said the EU has a role to play in combating cancer-causing infections. ‘As infectious diseases know no borders, there is a clear added value in addressing vaccine-preventable cancers and existing inequalities in access to vaccination, with a set of recommendations at the EU level,’ he said.
At a meeting held in the European Parliament late last year, a range of stakeholders, including MEPs, patient advocates and industry, signed a Call to Action urging policymakers to ensure HBV and HPV vaccination are included in updated National Cancer Plans.
The group also called for catch-up campaigns for vulnerable adults who may have missed HBV vaccination due to COVID-related disruptions and new awareness campaigns to highlight opportunities to protect against cancer-causing infections.
Cancer remains one of the biggest health challenges of our time, despite significant progress in recent decades in prevention, detection and treatment. Scientists are also exploring ways to use vaccine technologies to treat cancer by turning the immune system against cancerous cells.
In the meantime, public health authorities, doctors and the public should embrace the protective vaccines that have already been developed.