Program Highlights

The aim of the session is to provide clinicians with a practical and clinically relevant overview of how emerging molecular and computational methods may impact cervical screening and triage in the coming years, while also discussing important limitations in interpretation and implementation.

As the majority of the world has now adopted single dose HPV vaccination for adolescent girls, this session seeks to consider data for expanded use of single-dose HPV vaccination that will accelerate progress towards control of not just cervical cancer, but all HPV-driven cancers. The session will begin with the state of the science around single-dose HPV vaccination as well as a presentation in the gaps in knowledge. Then, the status of research studies, as well as results when available, will be presented on the following critical topics when considering expanded use for single-dose HPV vaccination: adult women using cervical and anal HPV endpoints, vulnerable women who acquire HIV, toddlers and males. The session will conclude with a presentation on global modeling work that identified the potential for increased cervical cancer inequalities worldwide without enhanced prevention efforts, as well as impact of expanded single-dose HPV vaccination of prevention of non-cervical HPV-driven cancers.

Solid organ transplant recipients experience substantially elevated rates of persistent HPV infection and HPV-associated malignancies. Chronic immunosuppression to prevent graft rejection alters viral clearance, immune surveillance, and tumor progression. As transplant survival improves and global transplantation rates increase, prevention of HPV-associated cancers in SOT recipients represents an urgent and under-addressed public health priority.

A major limitation of using visual methods in cervical cancer screening is the non-visibility of the transformation zone and the squamocolumnar junction. In low-resource settings, where follow-up visits after estrogen treatment or instrumental manipulation of the uterine cervix to visualize the TZ/ SCJ are nonexistent, management of these patients is unclear. Guidelines are generally not explicit enough or nonexistent. It is of key relevance to estimate the prevalence, risk factors, improved diagnosis and management of those cases in low-resource settings where a substantial proportion of women in screening age can have a non-fully visible SCJ, particularly after age 40 when over 40% of them may not have a visible SCJ.

This session at EUROGIN 2027 will review the current epidemiology of HPV-related cancer. Incidence, trends and the effect of HPV vaccine on HPV-cancer will be discussed.

The global elimination of cervical cancer has implementation of high-performance HPV-based screening as a most important step, that is rate-limiting regarding the timepoint when cervical cancer elimination will actually be achieved. However, many screening programs use a low-performance test (cytology) to triage HPV-positive women, reducing efficiency of programs. In addition, the complexity involved results in difficulties in implementation and operation of screening programs.

In the post-vaccination era, HPV prevalences have declined greatly. In addition, modern HPV screening methods allow more specific testing without jeopardizing sensitivity. There is therefore no reason to use cytology in the screening program, neither as a primary screening test, nor as a triaging test among HPV-positive women. Cytology-free cervical screening programs will be much easier to implement on a global scale.

-