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Experts warn cervical cancer will not be eliminated unless expertise of advocacy groups and the needs of women are reflected in screening strategies

5 Dec 2024
Experts warn cervical cancer will not be eliminated unless expertise of advocacy groups and the needs of women are reflected in screening strategies

Leading experts have warned that, despite the use of new technologies like HPV self-collection in selected countries, cervical cancer screening rates continue to stagnate or decrease globally.

They speculate that without profound change to how screening strategies are developed and implemented, women will continue to be impacted by cervical cancer and countries may fail to fulfil their objective of elimination.

Critical to this step-change is the need for innovative thinking and new collaborations that prioritise including the unique expertise and relationship with women that patient advocacy groups (PAGs) and women’s rights groups offer, alongside others such as researchers and policy makers working in cervical cancer prevention. With the elimination of cervical cancer as the goal, experts also called for the prioritisation of the needs of women who are under- or never-screened when developing new screening interventions and policies.

The ‘New Alliances: Building Collaboration in Cervical Cancer’ roundtable, sponsored by Hologic, a leader in global Women’s Health diagnostic solutions, brought together a wide range of influential stakeholders in cervical cancer including researchers, policy makers and PAGs to address declining cervical cancer screening participation and how this is slowing progress towards the World Health Organization’s (WHO) goal of eliminating this cancer.

The consensus at the meeting was clear: novel, collaborative thinking is needed to develop and test new screening strategies, with the commitment to scale-up effective interventions to inform local and national action plans as an urgent priority.

Athena Lamnisos, Chief Executive, The Eve Appeal, UK, and Co-Chair of the roundtable said: “We have an opportunity to make cervical cancer a disease of the past. But we won’t achieve WHO’s elimination goal unless we start focusing on and listening to under- and never-screened women and using their insights to think differently, develop innovative screening strategies and actually put these into practice. There are multiple, diverse barriers women and people with a cervix face that need addressing urgently - a ‘one size fits all’ solution is not enough.”

To achieve the WHO’s screening targets and make elimination a possibility, the expert group identified the following recommendations and next steps:

  • Multi-disciplinary stakeholder teams must include science working with the third sector. The unique value that PAGs bring to collaborations with researchers and policy makers working to stop the decline in cervical cancer screening participation, must be recognised. Critical to joint working will be ensuring a PAG, healthcare professional, researcher, policy maker and, where relevant, industry partnership is established at the planning stage of any cervical cancer screening project, so that expertise can be shared and bias addressed at the outset. Strategies found to be effective should then be scaled-up and funded to drive better outcomes. 
  • Under-screened women and those who are overdue for screening must be the priority. Stakeholders must understand and act on the needs of women, putting equity of care first. Many women who are under- or never-screened come from diverse communities or have personal barriers to accessing screening that must be addressed. Examples discussed included providing women with service options that meet their needs, e.g., provision of trauma-informed care, ensuring women are informed via suitable materials and channels such as information shaped for those with low health literacy, and appointments with female healthcare professionals.
  • Clear, intentional, innovative and prioritised plans. Targets are not enough, and countries need national elimination plans that can be nationally coordinated, but effectively delivered locally, and specifically address the needs of under- and never-screened women via systems that offer flexibility to users.

Dr Matejka Rebolj, Senior Epidemiologist, Wolfson Institute of Population Health, Queen Mary University of London, and Co-Chair of the roundtable said: “We have not yet found the answer to how to address declining cervical cancer screening rates across many high-income countries. Even with the introduction of innovative options such as self-collection, there has been no meaningful progress in improving the overall uptake in coverage.

One way to tackle this is to strengthen collaboration with the third sector. At Queen Mary University of London, we are launching a study to evaluate initiatives led by patient and women’s rights groups’ that aim to encourage everyone eligible for cervical cancer screening to participate. Our research will focus on the breadth of the approaches that have been developed, their effectiveness, and their potential for integration into routine screening programmes at scale. Ultimately, these insights will inform how researchers and patient and women’s rights groups can work together to drive the uptake of cervical cancer screening, saving more lives, together.”

Dr Alison Wiggans, Royal College of Obstetricians and Gynaecologists Council member and Consultant Gynaecological Oncologist said: “Too often, screening programmes are designed as rigid systems, where women are expected to fit the programme rather than the programme adapting to their needs. We need to change our thinking, look at what works in different communities, and act when women tell us there’s a problem with access.”

Patient advocacy groups involved in cervical cancer screening initiatives and interested in participating in the Queen Mary University of London study can contact the study lead, Ms Jane Rigney, at: jane.rigney@qmul.ac.uk.

The event closed with a reminder of the landmark opportunity to change the cancer landscape that cervical cancer represents from Athena Lamnisos: “Elimination is only in our sights if we engage meaningfully with women and people with a cervix in communities where we know screening rates are low, listen to their needs and learn from their experiences. We have started this conversation. We must continue to call on fellow patient groups and other key stakeholders to reach out, collaborate, and make this call to action a reality.”

Source: Hologic