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Jon Greenberg
By Jon Greenberg May 5, 2016

Joe Biden says cervical cancer 'totally preventable' in Africa

Vice President Joe Biden has called for a "moonshot" to cure cancer. The disease took his son in 2015, and now it has become his mission to eliminate some cancers and turn the rest into treatable, chronic diseases.

Biden took his campaign to the Vatican where he said that "nearly 50 percent of cancers are preventable."

"Take cervical cancer --  530,000 new cases are diagnosed each year," Biden said. "270,000 people die each year; 87 percent in developing countries. In Africa, it’s the second-most common cancer after breast cancer. It’s a travesty. But it’s fully preventable with basic education, screening, and vaccines."

Biden’s comment about cervical cancer in Africa caught our attention. Is cervical cancer fully preventable with the right interventions?

A fact-sheet on the Centers for Disease Control and Prevention’s website tells us that Biden is almost but not quite right.

"Every year in the U.S., more than 12,000 women get cervical cancer, and 4,000 die from it. 93 percent of cervical cancer deaths could be prevented through screening and HPV vaccination."

Now, that is for the United States with a system of doctors, clinics and hospitals that far surpasses anything found in any African nation. If it’s not fully preventable here, it’s difficult to see why the results in Africa would be better.

Beth Meyerson, a researcher at the School of Public Health at Indiana University is in the middle of a study on cervical cancer strategies in Africa. Meyerson told us "Sub-Saharan Africa would not be able to achieve 100 percent prevention."

Meghan Dubyak, a Biden spokeswoman, said the vice president was trying to make a slightly different point. "The vice president was referring to the travesty of cervical cancer being preventable," Dubyak said.

To be sure, cervical cancer is highly preventable. The journal Cancer Epidemiology, Biomarkers and Prevention, says "cervical cancer is a relatively rare disease in countries that have instituted and maintained national screening programs."

In this light, Biden’s statement draws attention to Africa’s unfortunate distinction.

As this World Health Organization map shows, it is a hotspot worldwide for cervical cancer.

In every dark blue country, the rate of new cases is over 30.2 per 100,000 women per year. By comparison, the rate in the United States is about 8.1 per 100,000 women per year. Of the 20 nations with the highest incidence of cervical cancer, 16 are in Sub-Saharan Africa. (Some researchers note there are vast gaps in this cancer data and say the true prevalence "remains largely unknown.")

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A 2015 report from the Sub-Saharan African Cervical Cancer Working Group, a body of physicians, epidemiologists and cancer researchers, described the key reasons behind the reach of the disease.

Screening is sorely lacking. The group found a "lack of widespread services, delays in receiving results, lack of the high-quality laboratories needed for cytology based screening and absence of adequate centres for the evaluation and treatment of identified patients."

Dealing with cervical cancer exposes the many cracks in the health care systems across the region.

Richard Wamai, assistant professor of public health at Northeastern University, said the countries of Sub-Saharan Africa are ill equipped for this challenge.

"Detection will require expanding the health service system, which requires investments in infrastructure," Wamai said. "That calls for prioritization which is difficult to do because of competing health demands. Cancer in general is, to me, the most worrying of all other diseases for the continent. There is very little preparation and in many cases policy makers are not yet awoken to this impending tsunami."

Public health experts also say vaccination programs are essential. Some strains of human papillomavirus (HPV) can lead to cervical cancer and some of those strains can be blocked by vaccines. But just as Sub-Saharan countries lack the infrastructure for screening, they also lack a system for vaccinating young women.

Speaking at a January 2016 event in Washington, Deborah Birx, U.S. Special Representative for Global Health Diplomacy, gave a bleak summary of the status of health care in Sub-Saharan Africa.

"There is no systematic health care for girls between the time they turn 5 and the time they get pregnant," Birx said.

That age range would be key for any vaccination program.

On top of that core challenge, Meyerson said the price tag for vaccines puts them out of reach.

"Many African countries find that the HPV vaccination cost is too high to have broad coverage," Meyerson said.

Our ruling

Biden said cervical cancer in Africa is "fully preventable with basic education, screening, and vaccines."

The experience of the developed countries shows that nearly all deaths from cervical cancer could be eliminated with widespread screening and vaccination programs. Neither currently exist in Africa, especially in Sub-Saharan Africa.

We rate the claim Mostly True.

Our Sources

Medium, What I Said at the Vatican About the World’s Efforts to Fight Cancer,  May 2, 2016

Africa Health, Human and Social Development Information Service, 2014  Africa Cervical Cancer Multi Indicator Incidence & Mortality Scorecard, 2014

World Health Organization, Cervical Cancer Estimated Incidence, Mortality and Prevalence Worldwide in 2012, March 5, 2016

International Agency for Research on Cancer, Cancer fact sheets, 2012

Centers for Disease Control and Prevention, Cervical cancer prevention, Nov. 5, 2014

Cancer Epidemiology, Biomarkers and Prevention, Cervical Cancer in Africa, July 17, 2012

South African Journal of Gynaecological Oncology, Consensus recommendations for the prevention of cervical cancer in sub-Saharan Africa, July 15, 2015

Queen Mary University of London, Global health experts call into question sub-Saharan cancer data, Feb.27, 2015

Email interview, Beth Meyerson, assistant professor, applied health science, School of Public Health, University of Indiana Bloomington, May 3, 2016

Email interview, Meghan Dubyak, spokeswoman, Office of the Vice President, May 4, 2016

Email interview, Richard Wamai, assistant professor of public health, Northeastern University, May 5, 2016

Interview, Deborah Birx, U.S. Special Representative for Global Health Diplomacy, Jan. 24, 2016

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Joe Biden says cervical cancer 'totally preventable' in Africa

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