ACCESS Consensus Group: Experts Warn of an Increase in Cervical Cancer if Under-screened Women Are Not Prioritised

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• Screening programmes remain the most powerful tool to reduce cervical cancer rates in the near term, but there is a concerning decline in participation in some countries
•  International Consensus Group urgently calls for governments and healthcare authorities to address low cervical cancer screening participation rates by prioritising under-screened women
• In their newly published White Paper, the Consensus Group provides key recommendations to support under-screened women, increase screening rates and address health inequities 

BRUSSELS, July 20, 2023 /PRNewswire/ -- The ACCESS (Advancing Cervical CancEr ScreeningS) International Consensus Group on Cervical Cancer today published a new White Paper, titled "Turning the Tide – Recommendations to increase cervical cancer screening in women who are under-screened", calling for urgent action from governments and healthcare authorities to address low and declining cervical cancer screening participation rates in high-income countries with established screening programmes. Crucially, the Consensus Group urges decision-makers to focus on initiatives targeted at under-screened groups of women, who are often from disadvantaged backgrounds and facing inequities that prevent them from attending screening appointments. 

Women who do not receive regular screening are at higher risk of developing cervical cancer, and when diagnosed, they are more likely to have advanced disease and poorer outcomes.1 At a time when countries should aim for the elimination of cervical cancer as an achievable target, women's lives are being put at risk due to low and decreasing screening rates. Prioritising under-screened women, and better understanding and addressing why they are not attending their screening appointments, will save lives and contribute to the timely elimination of cervical cancer. The time to act is now.

"While vaccination offers population-wide protection, screening is the most impactful prevention tool at our disposal for reducing the burden of cervical cancer in the coming years. It is alarming to witness sub-optimal participation rates in many high-income countries and a widening inequity among under-screened women. Our recommendations address these challenges head-on and provide a roadmap for improved accessibility to screening services, which will support the pathway to elimination." Philippe Descamps, Vice President of FIGO and co-chair of the ACCESS International Consensus Group on Cervical Cancer.

Since 2020, in response to the WHO Global Strategy to Accelerate the Elimination of Cervical Cancer, several countries have committed to eliminating cervical cancer with a dedicated national strategy. Many high-income countries, however, have yet to explicitly set an elimination goal. The Consensus Group calls on governments to change this and set locally relevant national action plans with ambitious goals for cervical cancer elimination, going beyond WHO targets, both to increase rates of screening and to reduce inequities in participation. A series of evidence-based recommendations and best practice examples, that are set to improve cervical cancer screening participation among under-screened women and support disease elimination goals, are provided in the Consensus Group's White Paper.

"The needs of women in communities where cervical screening uptake is low must be a vital priority. To ensure we reduce inequities, we need to better understand and develop interventions to address the barriers that many women face. We want to build on the success of cervical cancer screening programmes, strengthening the partnership between women and healthcare providers, and welcoming new technologies and innovations to prevent more cases of cervical cancer than ever before. By empowering women through information and support, especially from patient advocacy groups, I believe we have a great opportunity to bridge the gap in access to screening, and save more lives." Samantha Dixon, Chief Executive Officer of Jo's Cervical Cancer Trust, and co-chair of the ACCESS International Consensus Group on Cervical Cancer.

Evidence-Based Recommendations to Increase Participation in Screening Among Under-Screened Women 

The Consensus Group proposes a series of evidence-based recommendations and best practice examples to improve outcomes by increasing cervical cancer screening participation among under-screened women.

These range in priority order from:

1. Develop cervical cancer national elimination plans with goals for elimination by a defined date, including ambitious national screening programme participation targets at the population level
2. Implement targeted and culturally-relevant education, information and awareness-raising initiatives, particularly focused on under-screened women
3. Improve the accessibility of cervical cancer screening
4. Support healthcare professionals to increase participation in cervical cancer screening
5. Encourage and support the creation of national cervical cancer patient advocacy groups and national cervical cancer prevention coalitions
6. Ensure that health insurance appropriately covers screening in all high-income countries

As some countries are considering HPV self-sampling as a screening option to help address participation challenges, as part of its recommendations on improving the accessibility of cervical cancer screening, the Consensus Group also discussed the role of HPV self-sampling. The Consensus Group advises reserving self-sampling for habitual non-attenders at this time, while implementation challenges are addressed and regulatory reviews are conducted.

By implementing these recommendations, governments, healthcare authorities and communities can work together to improve outcomes by increasing cervical cancer screening participation among under-screened women. This ambitious vision requires immediate action. International collaboration between experts should be intensified to allow for more frequent and much-needed knowledge exchange and best-practice sharing. The Consensus Group urges decision-makers to implement the recommendations outlined in the White Paper, ensuring women have optimal access to cervical cancer screening, which is a vital cancer prevention tool.

To read the full White Paper, visit www.accesscg.org. 

Notes to editor

About Cervical Cancer and Screening

Cervical cancer is considered a major health concern worldwide, with over half a million new cases and more than 300,000 deaths each year.² The majority (>95%) of cervical cancer cases are caused by the human papillomavirus (HPV).³ It is preventable through vaccination and regular screening and can be treated if detected early. National screening programmes have proven to be successful in reducing the disease burden; since the 1980s, they have helped to reduce cervical cancer rates by up to 80%.⁴ Research in Europe has shown that women who attend regular screening reduce their risk of dying from cervical cancer by up to 92%.¹

About the ACCESS International Consensus Group on Cervical Cancer

The ACCESS International Consensus Group on Cervical Cancer consists of 10 world renowned experts from the EU, UK, US and Canada. The group was formed to initially investigate the cervical cancer screening state-of-play in high-income countries with established cervical cancer screening programmes due to concerns about sub-optimal participation rates and the negative impact on the health of disadvantaged groups. The Consensus Group members bring international expertise and pertinent insights from their own countries to contribute to improving cervical cancer screening programmes and ultimately reducing the burden of cervical cancer. 

To learn more about the members, visit www.accesscg.org.

The work of the ACCESS Consensus Group is supported by Hologic. Hologic has no editorial control over the content produced by the Consensus Group.

About the White Paper

The TURNING THE TIDE – RECOMMENDATIONS TO INCREASE CERVICAL CANCER SCREENING IN WOMEN WHO ARE UNDER-SCREENED White Paper was developed by the ACCESS International Consensus Group on Cervical Cancer and was informed by group members' insights from their field of expertise, contributions to a survey, two group discussions as well as an interview with an external expert in modelling targets for cervical cancer elimination. The findings are intended to ensure evidence-based policymaking to improve cervical cancer outcomes by increasing screening participation in under-screened women.

Contacts

For any queries regarding the ACCESS International Consensus Group on Cervical Cancer, please contact the group's Secretariat at: [email protected].

References

1.  Jansen EEL et al. Effect of organised cervical cancer screening on cervical cancer mortality in Europe: a systematic review. Eur J Cancer. 2020; 127: 207-223. DOI: https://doi.org/10.1016/j.ejca.2019.12.013.

2.  Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249.

3.  World Health Organization. Cervical Cancer. February 2022. Available at: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer. Last Accessed: July 2023.

4.  Koliopoulos G, Nyaga VN, Santesso N, et al. Cytology versus HPV testing for cervical cancer screening in the general population. Cochrane Database Syst Rev. 2017 Aug 10;8(8):CD008587.