ACCESS Consensus Group calls on the European Union and national governments to step up efforts in the fight against cervical cancer
ACCESS Consensus Group EU Policy Event “Turning the tide: Increasing participation in cervical cancer screening to save women’s lives”
European Parliament, Brussels
Hosted by: Tomislav Sokol MEP (EPP, Croatia)
On 25th January 2024, the ACCESS International Consensus Group on Cervical Cancer held a special EU policy event ”Turning the tide: Increasing participation in cervical cancer screening to save women’s lives” at the European Parliament in Brussels, hosted by Dr Tomislav Sokol MEP.
Cervical cancer is a leading cause of mortality among women. Each year, there are around 33,000 cases of cervical cancer and 15,000 deaths in the EU. It is one of the most preventable and treatable forms of cancer. For countries with organised screening and vaccination programmes, cervical cancer elimination is a realistic possibility in the coming years. We have the tools to prevent cervical cancer but stagnant and, in some countries, even declining uptake rates of these preventative measures are concerning. Screening is the most impactful single intervention to reduce the burden of cervical cancer in the short term, which is why urgent action is needed to boost participation rates. Increasing screening participation will help avoid women dying from this largely preventable disease.
The European Union institutions have an important role to play in responding to the unmet needs of under-screened populations and in helping safeguard their health by providing much-needed international visibility for the issue. In light of the upcoming update of the European Guidelines and Quality Assurance scheme for cervical cancer, the ACCESS Consensus Group believes it is critical to foster EU and international dialogue between policymakers, patient representatives and healthcare professionals to shine a light on the most recent scientific evidence and programmatic experience in the field of cervical cancer screening.
The recent event aimed to officially present the ACCESS International Consensus Group on Cervical Cancer and its White Paper “Turning the tide: Recommendations to increase cervical cancer screening among women who are under-screened”. It served as an impactful forum to encourage cross-sectoral collaboration which is essential to guarantee the full continuum of cervical cancer care, optimise outcomes, improve survival rates, and reduce the burden of the disease.
Event host Dr Tomislav Sokol, MEP (EPP, Croatia) opened the event by highlighting that healthcare is a central focus for the EU institutions, exemplified by Europe’s Beating Cancer Plan, which encompasses education, prevention, treatment, and post-cancer care. He clarified that, while healthcare is primarily a national competence, the EU can provide financing and propose screening projects to enhance awareness and reduce inequalities by sharing best practices from EU Member States.
Samira Rafaela, MEP (Renew Europe, Netherlands), and Sirpa Pietikainen, MEP (EPP, Finland) shared their European vision for increased efforts in cervical cancer care, emphasising the importance of gender inclusivity in healthcare equity, and how socioeconomic factors, stigma, and disadvantaged communities play an important role in accessing cervical cancer screening programmes.
Martin Hunt, Co-Chair of the ACCESS Consensus Group and CEO of Jo’s Cervical Cancer Trust UK, recognised the broader impact of cervical cancer, acknowledged challenges faced by individuals in less developed areas, and highlighted access issues, particularly for financially constrained women. He emphasised the importance of education, training for healthcare professionals, and action to empower women in making informed decisions, urging collective efforts to eliminate cervical cancer.
Prof. Philippe Descamps, Co-Chair of the ACCESS Consensus Group and former Vice President of the International Federation of Gynecology and Obstetrics (FIGO), France, highlighted cervical cancer as a significant issue in Europe and the potential of screening programmes to reduce mortality rates. He presented the ACCESS Consensus Group White Paper and its 6 key recommendations:
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 accessibility of cervical cancer screening.
4. Support healthcare professionals to increase participation in cervical cancer screening and encourage a partnership approach between healthcare professionals and patients.
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.
During the event’s panel discussion on ways to advance participation in cervical cancer screening among under-served groups, several strategies to engage EU Member States and improve screening participation were discussed. Dr Tomislav Sokol, MEP highlighted that financial incentives and engagement with minorities are a big priority to have better outcomes. Esra Urkmez, Patient Advocacy & Awareness Fundraising Director, ENGAGe, stressed the importance of working together with Patient Advocacy Groups but also with cancer survivors, healthcare professionals, industry and policymakers to have optimal results. She also shone a light on some of the specific groups of women who do not attend screening appointments and the barriers they face.
Ody Neisingh, Member of the ACCESS Consensus Group and Independent Consultant & Public Affairs Advisor, highlighted the declining cervical cancer screening participation rates in the Netherlands (over 60% in previous years to 46% in 2022). According to her, providing evening appointments for screening can be a very effective tool to increase screening participation. She expressed concerns that some women who use self-tests do not send their samples to their healthcare provider and that, while self-sampling was implemented seven years ago in the Netherlands, screening rates continue to decrease. Dr Matejka Rebolj, Senior Epidemiologist, at Queen Mary University of London, UK, highlighted the potential of new technologies in improving screening coverage. She explained that self-sampling is a viable option for under-screened women, offering convenience and privacy. She cautioned that offering self-sampling to all women raises issues, with the first data from countries that are already providing a self-sampling option being “not unanimously positive”. She further clarified that the accuracy of self-sampling tests is not as high as hoped and some women do not follow up after a positive self-test result. She concluded that self-sampling is better than no screening but is not a simple fix or a like-for-like replacement for clinician sampling.
Dr Partha Basu, Head of the Early Detection, Prevention & Infections Branch at the International Agency for Research on Cancer (IARC) described the decrease in cervical cancer screening rates as a humanitarian concern that impacts not only women but the whole family. He also presented the state of play and objectives of the ongoing update of the European Guidelines and Quality Assurance scheme for cervical cancer. Dr Mairead O’Connor, Member of the ACCESS Consensus Group and Research Officer at the National Screening Service of Ireland, presented Ireland’s recently announced 2040 target for cervical cancer elimination and highlighted Ireland’s recently developed national equity framework for screening. She further called out the declining cervical cancer screening rates in Ireland and outlined strategies that can help increase screening uptake such as tailored information and initiatives co-produced with the respective affected populations. She also called attention to the psychological impact of screening which is often overlooked.
Domenico Fiorenza, Cancer Policy Officer, at the Directorate-General for Health & Food Safety (DG SANTE) of the European Commission, presented the EU’s current efforts in cancer prevention and cervical cancer elimination. He highlighted the potential of initiatives such as Europe’s Beating Cancer Plan, the Horizon Europe Mission on Cancer, Member State Joint Actions, the European Cancer Information System and the European Commission Initiative on Cervical Cancer and encouraged health stakeholders to engage in active dialogue with the European Commission in the common fight against cervical cancer.
The Q&A session covered various topics including improving access to screening for disadvantaged populations such as minorities, the importance of patient advocacy groups, sharing best practices in screening and the implementation of the EU Cancer Screening Recommendation. Discussions also revolved around the importance of addressing gaps in knowledge and implementation and promoting education and awareness of cervical cancer screening.
ACCESS Consensus Group Co-Chair Prof. Philippe Descamps summarised the key takeaways from the discussions and concluded with a call to action to invest efforts in increasing participation in cervical cancer screening which is key to achieving the goal of eliminating cervical cancer.
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ABOUT THE ACCESS CONSENSUS GROUP
The Advancing Cervical CancEr ScreeningS (ACCESS) International Consensus Group on Cervical Cancer is made up of professionals with a broad range of experience and expertise in women’s health — focusing on cervical cancer from clinical, epidemiological, academic, patient, and advocacy perspectives. Together, we work to review the latest available evidence that supports optimal cervical cancer screening strategies in countries with organised cervical cancer screening programmes and make recommendations to relevant stakeholders and policymakers to advance women’s health by increasing the uptake of screening amongst under-screened women.
