FIGO’s eliminating cervical cancer project announces five new pilots

The five successful applications to the pilot project came from the Colombian Federation of Obstetrics and Gynecology (FECOLSOG), the Bengal Obstetric and Gynecological Society (BOGS), the Federation of Obstetric and Gynaecological Societies of India (FOGSI), the Nepal Society of Obstetricians and Gynaecologists (NESOG) and the End Cervical Cancer Nigeria Initiative (ECCNI).

More than half a million women are diagnosed with cervical cancer each year, and over a quarter of a million die from the disease. More than 85% of these deaths occur in low- and middle-income countries, with this figure expected to rise to 95% over time. Most of these countries do not have cervical cancer screening programmes or robust human papillomavirus (HPV) vaccination, while women in these countries often present with advanced disease not amenable to surgery.

The World Health Organization (WHO), along with FIGO and many global partners, sees a path to the eradication of this deadly disease through an emphasis on vaccination and screening. However, gaps exist in both professional and community education, sustainability of prevention strategies, and coordination of implementation in-country.

“We can realistically think of a world where no woman has to bear the terrible consequences of a cervical cancer diagnosis for herself and her family. Continuing efforts to support equitable access to HPV vaccination, screening and treatment of pre-cancerous lesions will help ensure no women or girl is left behind in the quest to eliminate cervical cancer, regardless of their background or where they live.”

– Dr Deborah Bateson, Medical Director, Family Planning NSW

The implementation and education strategies proposed by the five successful applicants to FIGO’s project will target cervical cancer elimination through a focus on two key elements: primary prevention via vaccination, and secondary prevention through cervical cancer screening. The projects aim to provide robust and scalable evidence on how to support the implementation of WHO-advocated strategies.

In the longer term, FIGO will support and work with the WHO to implement its guidelines and to increase uptake of vaccination and screening programmes. The revised WHO evidence-based guidelines on cervical cancer are expected to launch in the near future, offering FIGO and its member societies the opportunity to demonstrate the added value they bring to implementation work, with deep and expansive reach into the gynaecological community.

FECOLSOG, Colombia – Implementation of Screening and Prevention of Cervical Cancer in LMICs

Cervical cancer is the third-most common neoplasia in women in Colombia, accounting for nearly 50 deaths every week. Since an incident near Cartagena harmed trust in the HPV vaccine in 2014, vaccination rates have dropped considerably. To catch up with the global strategy to accelerate the elimination of cervical cancer, the project aims to reduce educational gaps that hinder HPV vaccination among teenagers, as well as screening in adult women. Over at least 36 months, the project will centre on a holistic approach, consisting of an educational programme that encourages different interest groups to interact with each other and to learn about the prevention of cervical cancer.

The Bengal Obstetric and Gynecological Society (BOGS), India – Integration of Smartphone in cervical cancer screening and Vaccination with Education dissemination (i–SERVE)  

This project aims to integrate mobile application technology with cervical cancer screening and HPV vaccination, with a particular focus upon the feasibility and acceptability of the app in rural areas. The app, available in local languages, will support individuals with HPV self-sampling, assess vaccine eligibility, record screening and vaccination data, and will also send SMS reminders for vaccination and screening appointments. The app will also support healthcare providers to set up appointments, enabling a “screen, see and treat” approach. If found feasible and acceptable by this study, the app will be available for use on a larger scale.  
  

End Cervical Cancer Nigeria Initiative (ECCNI), Nigeria – Capacity Building for Outpatient Clinics to Improve Adolescent Vaccine Uptake and Women’s Demand for Cervical Cancer Screening

This proposal aims to encourage HPV vaccination uptake among adolescents in Nigeria, while at the same time encouraging eligible women to seek cervical cancer screening. The project will use information, communication and education (ICE) approaches with outpatients as a vehicle for promotion. Selected gynaecologists, spread across the 36 states of the Federation and the Federal Capital Territory, will be trained in social behaviour change communication skills relevant to the HPV vaccination campaign. They will subsequently be asked to institute patient enlightenment programmes in their respective clinics. The results will be used for advocacy to both federal and state ministries of health for national and state-wide scale-up of best practices.

FOGSI, India – Augmenting Cervical Cancer Elimination Effectively in a Region utilising Affordable TEchnology (ACCELERATE) to enhance cervical cancer screening services and achieve WHO target goals in the north-east region of India

The North Eastern Region (NER) of India bears a huge burden of cervical cancer. Effective implementation of already available guidelines and screening services remains a daunting challenge. This study is designed to assess the feasibility and efficacy of a multi-pronged approach consisting of HPV testing with an option of self-sampling, portable colposcopy and treatment in the same sitting for strengthening the elimination targets in the region. Additionally, it aims to develop a prototype for aligning effective and sustained screening practices. The current study is likely to provide an overview of existing barriers to screening services and impact of a novel strategy for effective screening practice and promoting participation.

NESOG, Nepal – Implementation of screening and prevention of cervical cancer in LMICs

This project will generate evidence and identify key gaps in the prevention of cervical cancer in Nepal and outline a roadmap for sustainable solutions. The gaps will be explored across various levels of the health system from policy to health facilities. The project will also explore understanding across the education sector, such as medical colleges, nursing schools and high schools. Findings will be triangulated through robust analyses and disseminated through a national consultative meeting with key stakeholders to initiate dialogue and further advocacy. The meeting will also incorporate a workshop to identify how to effect policy change and incorporate cervical cancer screening and HPV vaccination as part of national programmes.