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Title: Cancer elimination thresholds: one size does not fit all - Authors' reply
Authors: Hall M; Smith MA; Brotherton JM; Simms KT; Canfell K
Categories: Cancer Type - Cervical Cancer
Year: 2019
Journal Title: Lancet Public Health
Volume: 4
Issue: 2
Abstract: In our analysis of the timeline for cervical cancer elimination as a public health issue in Australia,1 we considered two potential thresholds. These thresholds were the rare cancer threshold (often considered as six cases per 100 000 women in Europe and Australia), and a lower threshold of four cases per 100 000 women. We concluded that Australia is on track to reduce cervical cancer below four cases per 100 000 before 2035. In their Correspondence, Alejandra Castanon and colleagues posit that an elimination threshold of four per 100000 “is too easy for some countries and impossible for others”. As we made clear in our study, the process of defining an appropriate threshold for the elimination of cervical cancer as a public health problem is still underway and we agree that defining a threshold that is appropriate for global use and advocacy is indeed challenging. We suggest that if a threshold is defined as a number of incident cases per 100000 women per year, it should be conceived as a target for achievement by active intervention, for example, deployment of the two proven prevention strategies (prophylactic HPV vaccination and cervical screening) to prevent cancer cases that would otherwise occur in that population.
Division: Cancer Research Division
Funding Body: MTH, MAS, KTS, and KC report grants from the National Health and Medical Research Council (Australia) during the conduct of the study. KC is a co-principal investigator of Compass (NCT02328872), which is conducted and funded by the Victorian Cytology Service (VCS), a governmentfunded health promotion charity. The VCS has received equipment and a funding contribution for the Compass trial from Roche Molecular Systems and Ventana (now Roche Tissue Diagnostics). KC is also a principal investigator on the Compass trial in New Zealand (Compass NZ; ACTRN12614000714684), which is conducted and funded by Diagnostic Medlab (now Auckland District Health Board). J
DOI: 10.1016/S2468-2667(18)30258-5
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