Working collaboratively with vulnerable women to identify the best implementation gains by screening cervical cancer more effectively in European countries

Project Information

CBIG-SCREEN

Grant agreement ID: 964049

DOI

10.3030/964049

Project closed

EC signature date 2 February 2021

Start date 1 March 2021

End date 28 February 2026

Funded under

• SOCIETAL CHALLENGES - Health, demographic change and well-being

Total cost

€ 3 661 850,00

EU contribution

€ 3 661 850,00

Coordinated by

INSTITUT NATIONAL DE LA SANTE ET DE LA RECHERCHE MEDICALE
France

Periodic Reporting for period 3 - CBIG-SCREEN (Working collaboratively with vulnerable women to identify the best implementation gains by screening cervical cancer more effectively in European countries)

Reporting period: 2024-03-01 to 2025-08-31

Summary of the context and overall objectives of the project

Cervical cancer (CC) is the second most common cancer among women under 45. Every year in Europe, nearly 26,000 women lose their lives to a disease that is largely preventable. This high toll is mainly due to low vaccination rates and limited access to screening among vulnerable women. Although screening can drastically cut mortality, many women still face barriers to participation, deepening health inequalities across Europe.
CBIG-SCREEN is committed to changing this. The project works to improve access to cervical cancer screening for women in vulnerable situations — including those with low income, living with HIV, incarcerated, migrants or sex workers. Together with these women, CBIG-SCREEN develops practical, inclusive strategies to make screening more approachable, ensure follow-up to treatment, and ultimately improve health outcomes.
By maintaining a continuous dialogue with policymakers, the consortium aims to integrate these strategies into national screening programmes, ensuring they truly reach the women who need them most.
Across Europe, CBIG-SCREEN is building a knowledge framework to better understand barriers to screening and to create effective policies, communication tools and support services tailored to high-risk women. The project’s goal is ambitious yet achievable: increase screening participation from 26% to 45% — potentially saving 6,000 to 7,000 lives every year.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

WP1 – Project Coordination and Management
WP1 ensures that the project meets its objectives through effective coordination and management. The coordination team has closely monitored progress, organising two annual and three-monthly Executive Committee meetings, as well as a meeting with the independent Ethics Advisory Board.
WP2 – Stakeholder engagement
WP2 maps existing cervical cancer screening (CCS) policies, particularly those aiming to broaden coverage among vulnerable women (VW). It also identifies key stakeholders and their views on barriers and potential solutions. An online survey across all EU countries revealed that few have policies dedicated to increasing CCS participation among VW. An interactive stakeholder map was developed, and Collaborative User Boards (CUBs) – including VW, healthcare professionals, and decision-makers – were set up in seven partner countries.
In total, 120 stakeholders participated in these discussions to tailor interventions for the project. Three scientific papers on CUB findings have been published.
WP3 – Co-creating tailored interventions to improve cervical screening access for vulnerable groups
WP3 aims to improve CCS access for VW through evidence-based and feasible measures. A conceptual model from the EU-TOPIA project was adapted to identify barriers faced by VW. The literature review on barriers and facilitators to CCS participation among VW groups in Europe has been completed.
Co-creation activities took place in Romania (Think Aloud study), Estonia (prioritization exercise), and Bulgaria (digital storytelling). These provided valuable insights to inform WP6 pilot interventions, policy dialogues, and publications. WP3 has fully achieved its objectives and delivered outputs with lasting impact.
WP4 – PBehavioural determinants and societal issues in targeted CCS programmes
WP4 supports the design of targeted CC prevention policies by analysing VW preferences and identifying societal implications of their implementation. Using a Discrete Choice Experiment, WP4 highlighted heterogeneity in preferences, particularly for self-sampling, confirming the need for tailored approaches.
Societal issues and ethical dimensions were documented through analyses of normative frameworks and a typology of European targeted interventions. A decision tree now summarises the key steps for designing effective, equitable interventions.
WP5 – Model development and cost effectiveness assessments
WP5 evaluates the cost-effectiveness of tailored CCS strategies to increase participation among VW. A systematic review of economic evaluations revealed limited evidence for specific vulnerable groups. WP5 has begun costing exercises and model conceptualisation, laying the groundwork for robust economic assessments of future interventions.
WP6 – Pilot testing of the co-created tailored CCS strategies in real-life settings
WP6 supports the co-creation, implementation, and evaluation of tailored CCS strategies in Estonia, Portugal, and Romania. After assessing national screening capacities, protocols and data collection tools for Phases I and II were developed. Phase I has been completed in all three countries; Phase II has finished recruitment in Estonia, and is ongoing in Portugal and Romania.
WP7 – Maximising Impact
WP7 promotes CBIG-SCREEN and maximises the dissemination of its findings to a broad audience. Activities included regular social media updates (transitioning from X to BlueSky), publication of the second CBIG-SCREEN newsletter, and organisation of a second roundtable at the European Parliament in collaboration with other H2020 projects.
CBIG-SCREEN hosted the roundtable, where policy recommendations and an intervention toolkit were presented. Several scientific articles have also been submitted and/or accepted for publication.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

Advancing the perspectives of stakeholders, including vulnerable women (VW), helps select the most appropriate interventions to increase cervical cancer screening (CCS) coverage and tailor them to specific contexts for successful implementation.
By collaborating with those most affected, CBIG-SCREEN identifies barriers that disproportionately impact VW and explores how to improve CCS both within and outside traditional healthcare settings. Engaging a broad range of stakeholders helps define the key components of an accessible CCS pathway.
The project also contributes to understanding the real-life impact of targeted CC prevention policies, as effectiveness depends on contextual factors often missed by quantitative methods. This will inform WP3 in providing precise and realistic estimates of the cost-efficiency of such policies.
A systematic review revealed limited evidence on the cost-effectiveness of increasing screening participation among specific vulnerable groups. The protocol and tools developed to assess the capacity of CCS-related services can be used by health systems in other countries before introducing new interventions.
Finally, the project’s communication activities have reached a broad audience, highlighting the importance of targeting vulnerable and hard-to-reach women to improve CCS uptake. CBIG-SCREEN continues to engage policymakers, health professionals, and women themselves to mitigate barriers and promote equitable access to screening.

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