Human papillomavirus: The unknown disease affecting PNG women

IT causes the most common cancer among women in Papua New Guinea, but few know its name.
It kills 1,500 PNG women each year, but these deaths could have been prevented through a combination of vaccination and access to cervical cancer screening and treatment.
Human papillomavirus (HPV) is the hidden enemy that causes cervical cancer, which PNG ranks among the highest in the world.
There are many different types of HPV virus that can cause cervical cancer but it is estimated that two types (HPV16 and HPV18) causes around 70%-75% of cervical cancers worldwide.
The good news is that a highly-effective vaccine is now available that protects against infection with these two types of HPV.
Vaccination programmes to prevent HPV infection have been introduced in many countries worldwide, including lower and middle income countries such as Fiji, Malaysia and Nepal.
Yet, in PNG, we know almost nothing about how much HPV there is in the community or whether the specific types of HPV that are common here are the ones that the vaccine is designed to protect women.
The PNG Institute of Medical Research is carrying out the first large-scale surveys to look at HPV infection in PNG and asking women coming to antenatal clinics, sexual health clinics and Well-Woman clinics across the country to take part.
The research will provide the first information on HPV in PNG and help the government and donor partners decide if vaccinations should be introduced here.
The programme is being conducted in partnership with the University of PNG, Health Department and provincial health authorities and is supported by research grants from the government, AusAID and the ExxonMobil partnership in health programme.
Cervical screening programmes, based on women having regular Pap smear examinations, have been in operation for many years worldwide.
In PNG, the MeriPath Pap smear programme has successfully screened more than 45,000 women in the past 10 years, but experienced difficulty screening women in rural areas and in providing results to those women who need further treatment.
A Health Department ministerial task force recommended in 2009 that alternative approaches to cervical screening be piloted in PNG.
Screening programmes based on the use of simple dyes have been successfully used in Bangladesh, India, Thailand and other developing countries.
This approach is now being piloted at two provincial hospitals in the highlands region, where Dr Antonia Kumbia and Dr Benny Kombuk are working with Prof Glen Mola from the University of PNG and the IMR research team on a study that will help to establish if this is the best way ahead for cervical cancer screening in PNG.