Health
HPV testing key to eliminating cervical cancer in Canada
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Implementing human papillomavirus (HPV) testing in British Columbia could help eliminate cervical cancer in the province by 2040, a Canadian modelling study has found. CMJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.231682.
More than 90% of cervical cancer cases worldwide are caused by nine types of high-risk HPV. Both the World Health Organization and the Canadian Partnership Against Cancer (CPAC) have set a goal of eliminating cervical cancer by 2040, defined as an annual incidence rate of less than four cases per 100,000 women.
While Pap testing has been the primary screening tool for decades, HPV-based screening has shown greater accuracy in detecting pre-stages of cervical cancer, and access and adoption is increasing because HPV-based screening can be performed on samples collected by patients rather than by their health care providers.
“Self-collection options could reduce access barriers and increase testing uptake among people who have never been or are undertested previously.” lead author Rekha Pataky, PhD, of the Canadian Centre for Applied Research in Cancer Control and BC Cancer in Vancouver, British Columbia, and her co-authors wrote.
Using CPAC's OncoSim-Cervical model, researchers developed scenarios that could help BC reach its goal of eliminating cervical cancer. With current Pap testing, BC would not reach the goal of 4 cases per 100,000 until 2045 without changing HPV vaccination rates or screening participation rates. With HPV-based screening, BC could reach the goal by 2034 and prevent more than 900 cases of cervical cancer by 2050.
There are concerns about increased demand for colposcopies to investigate abnormal results and pre-cancer treatments due to HPV-based screening. The authors suggest that a phased introduction of HPV testing according to age could reduce the burden on the healthcare system.
“Screening programs across Canada need to implement HPV-based cervical screening in strategic and innovative ways that increase access to screening services, enhance timely follow-up and treatment, and reduce health disparities across the population.” they conclude.
In a related editorialhttps://www.cmaj.ca/lookup/doi/10.1503/cmaj.240722Dr. Shannon Charlebois, Medical Editor CMJand Dr. Sarah Keene, a gynecologic oncologist at the University of Manitoba, wrote that cervical cancer is increasing among younger people and is more common among equity groups.
“Invasive cervical cancer disproportionately impacts those seeking equity,” those people write. “Yet those most at risk – 2SLGBTQI+ people, migrants, people with disabilities, Black and Indigenous people and survivors of sexual trauma – are the least likely to be tested. This is the most common cancer among HIV-positive women.”
Self-sampling has been shown to be as accurate as doctor-collected samples and may lead to improved access to cervical cancer screening among these groups.
“For Canada to eliminate cervical cancer, it is entirely possible, and every health system across the country must incorporate self-sample collection into their cervical cancer screening programs.”
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Journal References:
Pathak,bid, other(2024) Strategies to accelerate cervical cancer elimination in British Columbia, Canada: a modelling study. CMJ. Translation: doi.org/10.1503/cmaj.231682.
Sources 2/ https://www.news-medical.net/news/20240603/HPV-based-screening-key-to-eliminating-cervical-cancer-in-Canada.aspx The mention sources can contact us to remove/changing this article |
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