Sciensano's cancer centre contributed to a new paper on the IARC Perspective on Cervical Cancer Screening
In the latest issue of New England Journal of Medicine (NEJM), a Working Group of 27 international scientists led by IARC (International Agency for Research on Cancer) has summarized the current evidence on cervical cancer screening. The working Group concluded that screening with a validated HPV (human papillomavirus) test is more effective than cervical cytology (microscopic examination of a Pap smear) among women of 30 years of age or older. The working group also concluded that the benefits of screening with co-testing (use of both cervical cytology and a HPV test) do not outweigh the harms
HPV detection involves an objective molecular test that identifies the virus which causes nearly all cervical cancers, whereas cervical cytology is more subjective and consequently less reliable. An additional advantage of HPV testing is that it can be performed on a vaginal self-sample collected by the woman herself. A systematic review has shown that HPV testing is as accurate on a self-sample compared to a sample taken by a health professional, under the condition of using an adequate assay (validated assay that detect viral DNA based on a PCR principle). Several systematic reviews that generated the scientific evidence of the IARC assessment have been conducted at the Belgian Cancer Centre of Sciensano. By offering self-sampling kits more women can be reached who otherwise do not participate regularly at screening.
Besides the use of an accurate screening test, successful prevention of cervical cancer requires reaching high population coverage, quality-assured health systems that can provide adequate follow-up and adequate management of women with a positive HPV test. Alongside the scaling up of HPV vaccination and cancer treatment, increasing global levels of screening and treatment of precancerous lesion will bring the elimination of cervical cancer as a public health problem within reach.
Learn more about this paper: https://www.nejm.org/doi/full/10.1056/NEJMsr2030640