| Criteria | Marks |
|---|
| Provides an extensive evaluation of the success of the campaigns on the incidence of cervical cancer based on a detailed analysis of the stimulus; provides a well-informed judgement as to the success of the campaigns | 6 |
| Provides a thorough evaluation of the success of campaigns on the incidence of cervical cancer based on an analysis of the data; provides an informed judgement as to the success of the campaigns | 5 |
| Provides an evaluation of the success of campaigns on the incidence of cervical cancer with reference to the data; provides a judgement | 4 |
| Provides some points about the effect of the campaign(s) on the incidence of disease; makes link(s) to the data | 2–3 |
| Provides some relevant information | 1 |
Sample answer:
The national screening program that started in 1991 is followed by a large drop in the incidence of the disease, to about half, and therefore appears to have been effective in preventing the disease. However, it is not possible from these numbers to imply that the program was the cause of the drop as other factors may have changed concurrently. Also, incidence was dropping before 1991 and this decrease may have continued without the program.
Because human papillomavirus (HPV) causes most cervical cancers, vaccinating young girls against HPV could be an effective strategy for disease prevention in addition to screening. A program that includes vaccination of the whole population including boys will reduce the circulating viral load and is expected to add to the effectiveness. However, the data do not show a reduction in the incidence of cervical cancer since the beginning of these vaccination programs. This could be because the screening program is already very effective, or because the vaccines are delivered to young, school aged students and cervical cancer is likely to develop over several years and become evident in older women. Although it is expected that the incidence will reduce as a greater proportion of the total population is vaccinated, the effectiveness of each campaign separately cannot be assessed from these data.
The data show it is likely that public health programs are effective for preventing disease but they need to be continued for many years as well as studied separately before the effects can be properly assessed.
