Elimination Through Collaboration

In 2018, the World Health Organization (WHO), announced a global call for action to eliminate cervical cancer (1) and we’re already seeing some promising targets set. For example, healthcare services in England and Ireland have pledged to eliminate cervical cancer by 2040 (2,3).

However, data from year three of Hologic’s Global Women’s Health Index revealed that in the UK, fewer than 1 in 5 women were tested for cancer (4). For cervical cancer specifically, NHS England data shows that more than five million are not up to date with their routine check-ups (5). 

This comes alongside the recent closure of Jo’s Cervical Cancer Trust – a crucial organization which pushed the elimination target – making it more important than ever for experts to work together to drive screening uptake and protect future generations from this devastating, yet preventable, disease.

At a recent roundtable during the IPVC conference, stakeholders across policy, research, and patient advocacy groups discussed this much needed collaboration. And here’s what we learnt.

Learn from lived experience
 

To address screening barriers for women, we must first understand them by studying communities with lower screening rates. This is where patient advocacy groups are particularly critical, as Athena Lamnisos, Chief Executive of The Eve Appeal and co-chair of the roundtable, commented:

“We have an opportunity to make cervical cancer a disease of the past. But we won’t achieve this goal unless we start focusing on and listening to under- and never-screened women and people with cervixes, and using their insights to think differently, develop innovative screening strategies, and actually put these into practice.”

It's only with these insights, that we can truly create effective solutions.

Tailor outreach to the community
 

As Martin Hunt, former CEO of Jo’s Cervical Cancer Trust, commented, “For screening uptake to increase, we need systems that truly reach women in ways they understand and trust. Patient advocacy groups must take the lead, collaborating closely with clinicians, researchers, and policy makers to build care pathways that reflect how women actually access services.”

To deliver meaningful action, we need to move beyond listening mode – and this is not a one size fits all approach. Local initiatives have successfully improved screening access for under-screened women. For example, in Dublin, the Irish National Screening Service partnered with Pavee Point and the Irish National Cancer Control Programme to address barriers faced by the Traveller Community. By collaborating with Traveller Primary Health Care workers, they implemented targeted interventions, overcoming challenges like literacy issues and enabling more Traveller women to be screened (6).

Screening programs must remain adaptable to address local needs. This includes providing health information in multiple languages, offering flexible appointments, and allowing patients to choose a female healthcare professional.

Deliver national change
 

It’s crucial that we learn from these local learnings and initiatives to implement change on a national scale. We’ve already seen promising developments, such as the ‘ping and book’ system in England that reminds women of breast and cervical screening appointments, and allows them to book appointments via the NHS app (7).

We are also seeing further discussion on the role of HPV self sampling, with recent English data showing that when it comes to choosing between this and a clinician screening, 48 percent of women would prefer to receive a recommendation of which method to use (8).

Commenting on a promising new international study, 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 suboptimal cervical cancer screening rates. Even with the introduction of innovative options such as self-collection, there has been no meaningful progress in improving the overall uptake in coverage.”

Rebolj continued, “At Queen Mary University of London, alongside Jane Rigney, 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. 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.”

For the first time ever, we have the opportunity to eliminate a type of cancer, yet it's clear that much more needs to be done to make this goal a reality, and collaboration is crucial to achieve this.