Cervical cancer caused by persistent infection with high risk humanpapilloma viruses (HPV) is one the most preventable and curable of all cancers.However,it is the second most common cancer in women world-wide.Attempts to eradicate cervical cancer began over 50 years ago with secondary prevention in the form of cervical screening with the Pap smear and have progressd to primary prevention with the recent development of prophylactic HPV vaccines.These vaccines are now licensed in over 85 countries world-wide,but not in Japan.This paper will examine attitudes and policies towards cervical screening and HPV vaccination implementation in 4 countries:Australia,the United Kingdom,the United States and Japan.
A literature review of screening methods,uptake rates,vaccine implementation and attitudes to both of these preventative methods was undertaken for each country.Participation rates in cervical screening programs in Australia,the United Kingdom,the United States and Japan are about 61%,84%,82% and 20%,respectively.HPV vaccines have been licensed in the former 3 countries for women aged 9-26 years since 2006 but are not scheduled to be licensed in Japan until 2011.Both Australia and the United Kingdom have free school-based vaccination programs.In the United States the vaccine is covered by the vaccine for Children Program.
Onset of sexual activity is becoming younger in all 4 countries and the number of sexual partners teenage girl have is increasing.Sexually transmitted infections are also rising in each country.HPV is the most common sexually transmitted infection in the world.With delayed implemtation of the HPV vaccines and poor cervical cancer screening rates,young women in Japan will have a higher risk of developing cervical cancer and at a younger age compared with their counterparts in Australia,the United Kingdom and the United States.
