New recommendations for screening and treatment to prevent cervical cancer

“Effective and affordable cervical screening and treatment programs in every country cannot be negotiated if we stop the unimaginable suffering caused by cervical cancer”, Says Dr. Princess Nono Simelela, Assistant Director General for Strategic Program Priorities: Elimination of Cervical Cancer. “This new WHO guideline will lead investment in public health to better diagnostic tools, stronger enforcement procedures and more acceptable screening options to reach more women – and save more lives. “

A shift in care

New guideline include some important developments in WHO recommendations in cervical examination.

He especially recommends the HPV DNA test as the preferred method, instead of visual inspection with acetic acid (VIA) or cytology (commonly known as the “Pap test”), currently the most commonly used methods for detecting precancerous lesions.

HPV-DNA testing reveals high-risk strains of HPV that cause almost all cervical cancers. Unlike tests that rely on visual inspection, HPV-DNA testing is an objective diagnosis, leaving no room for interpretation of results.

Although the procedure for a healthcare provider taking a cervical sample is similar to cytology or HPV DNA testing, HPV DNA testing is simpler, prevents more precancers and cancer, and saves more lives than VIA or cytology. In addition, it is more cost-effective.

Greater access to goods and sampling itself is another path to consider to achieve the goal of a global strategy of 70% testing by 2030.

The WHO suggests that self-collected samples can be used to provide HPV DNA testing. Studies show that women often feel more comfortable taking their own samples, for example in the comfort of their own home, instead of going to an examination provider. However, women need to receive appropriate support in order to feel confident in managing the process.

The recommendations respond to the link between HPV and HIV

Immune-weakened women, such as those living with HIV, are particularly susceptible to cervical disease; they are more likely to have permanent HPV infections and faster progression to precancer and cancer. This results in a six times higher risk of cervical cancer among women living with HIV.

In recognition of this, the new guidelines include recommendations specific to women living with HIV. This includes the use of a primary HPV DNA screening test followed by a triage test if the results are positive for HPV, to assess the results of cervical cancer risk and the need for treatment. Global recommendations also advise that screening begin at an earlier age (25 years) than for the general female population (30 years). Women living with HIV should also be retested after a shorter time interval after a positive test and after treatment than women without HIV.

“With these new guidelines, we must use the platforms already developed for HIV care and treatment to better integrate cervical cancer screening and treatment to meet the health needs and rights of a diverse group of women living with HIV to increase access, improve coverage and saved lives”Dr. Meg Doherty, Director, WHO Division for Global Programs for HIV, Hepatitis and Sexually Transmitted Infections.

Any intervention is important to remove cervical cancer

Data showing where countries around the world currently stand in relation to their cervical cancer burden and screening and treatment coverage should be published by the end of 2021. These country profiles can help ministries of health identify where their programs need to strengthen and measure progress toward targets. 2030

In order for the cervical cancer prevention and control program to have an impact, strengthening patient retention and ensuring prompt treatment for women who test positive for HPV or cervical precancer is a fundamental priority.

“The cost-effectiveness of screening tests is important for expanding the program, but other aspects of the public health approach to cervical cancer removal are also vital”, Said Dr. Nathalie Broutet, Department of Sexual and Reproductive Health and WHO and HRP Research. “The most important thing is the coherence of each country’s program to ensure continuity of care: that all women have access to screening, health care providers are informed of screening test results in a timely manner and can share this information with their clients.. ”

The WHO calls on all women to provide regular screening tests for cervical cancer in accordance with the recommendations of their local health authorities.