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Making cervical cancer in Europe a thing of the past

An EU-backed initiative is developing risk-based screening to eliminate cervical cancer.

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Cervical cancer is one of the few cancers that is almost completely preventable if detected early. Despite this, in Europe over 58 000 new cases and nearly 26 000 deaths were reported in 2020. More effective and efficient screening is needed to eliminate cervical cancer as a public health problem. To address this issue, the EU-funded RISCC project is introducing a risk-based screening approach. To create risk profiles from screening history, it is using data from several large human papillomavirus (HPV) screening trials across Europe. HPV is the most common sexually transmitted infection and causes virtually all cases of cervical cancer. The World Health Organization recommends using HPV testing as the primary screening method for preventing cervical cancer. However, the efficiency and efficacy of HPV-based screening programmes need to be improved.

Gaining insight into the safety of HPV-based screening intervals

The researchers gathered follow-up data of women who participated in a trial in the Netherlands during an enrolment period from 1999 to 2002. They chose 18 448 women with a negative HPV outcome at the second study-related screening round (5 years after enrolment) and grouped them based on screening results during the study enrolment. Results showed that HPV negative women had a greater long-term risk of cervical intraepithelial neoplasia (CIN) grade 3 or higher when the HPV test in the previous screening round was positive. CIN is the abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer if not treated. CIN is classified in grades, with 3 being the most abnormal. The research supports implementing risk-based intervals that rely on HPV results in the existing and previous screening rounds. The findings were published in ‘PLOS Medicine’. “Our study confirmed the safety of extending the screening interval from 5 to 10 years among HPV–negative women who were also screen-negative at the previous round,” the authors conclude. “A history of HPV positivity, even when the current result is negative, is associated with a long-term increased precancer risk that warrants a re-evaluation of the extended 10-year screening interval. Altogether, our results indicate that HPV results from multiple screening rounds should be considered when determining the time to the next screening invitation.” Ending in December 2024, the RISCC (RISK-BASED SCREENING FOR CERVICAL CANCER) project is developing and evaluating the first risk-based screening programme for cervical cancer and providing open-source implementation tools. If you are interested in having your project featured as a ‘Project of the Month’ in an upcoming issue, please send us an email to editorial@cordis.europa.eu and tell us why!

Keywords

RISCC, cancer, cervical cancer, screening, human papillomavirus, cervical intraepithelial neoplasia