Quick Summary

In this article, Lab Insights summarises the key takeaways from AOGIN 2024. The bi-annual conference was held in Seoul, South Korea, this year, with the theme “Empowering Women, Together against Cervical Cancer”.

Prof Young-Tak Kim, President of AOGIN, discusses AOGIN’s recently released 2024 Position Statement to improve cervical cancer screening in the region.

Interview transcript:

Introduction

My name is Young-Tak Kim, a gynecologic oncologist and president of AOGIN. Also, the CEO of CHA Global and Women’s Hospital.

What is AOGIN’s goals for cervical cancer screening?

AOGIN, the Asia Oceania Research Organization in Genital Infection and Neoplasia was founded 20 years ago with 22 member countries, focuses on improving cervical cancer screening and prevention in the Asia-Oceania region.
Their goals include increasing awareness, enhancing screening programs, improving assess, and developing new guidelines.

The 2024 AOGIN Position Statement for Cervical cancer screening was announced at the recent AOGIN 2024. Please briefly introduce the AOGIN Position Statement.

The AOGIN Position Statement outlines key recommendations from 14 countries for enhancing cervical cancer screening in the Asia-Oceania region.
The statement aims to guide countries in improving screening programs, increasing access for underserved populations, and integrating HPV vaccination efforts.

Why is it important to use clinically validated HPV tests, especially for primary screening?

The 2024 AOGIN Position Statement emphasizes the importance of clinically validated HPV tests for primary cervical cancer screening, aligned with the WHO goals for effective cancer prevention and control.

Clinically validated HPV tests have a higher sensitivity compared to traditional Pap smears, meaning they are more effective at detecting cervical pre-cancerous lesions and cancer.
Also, HPV testing allows for longer intervals between screening, typically every 5 years, reducing the frequency of unnecessary exams and associated healthcare costs while still maintain high safety standards.
Lastly, HPV testing provides better stratification of risk of progression. Positive result can lead to immediate follow-up and management, while negative results offer reassurance for longer periods.

Why is it important for those 25-65 years to undergo testing?

It’s important for individuals aged 25 to 65 to undergo cervical cancer screening not only for early detection, but for effective prevention and risk stratification. By ensuring regular screenings, individuals can significantly contribute to their health and well-being while helping to lower the overall incidence of cervical cancer in the community.

What are AOGIN’s upcoming plans for HPV testing and cervical cancer elimination in the APAC region?

AOGIN has several upcoming plans focused on HPV testing and cervical cancer elimination in the APAC region.
First, AOGIN plans to advocate for the widespread adoption of clinically validated HPV testing as the primary screening method, emphasizing its effectiveness in early detection.
Also, AOGIN aims to work closely with government health departments to integrate HPV testing into national screening programs and align policies with international guidelines.
Lastly, ongoing research to gather data on HPV prevalence and cervical cancer incidence in the region will support evidence-based decision-making and policy formulation.

What countries does AOGIN plan to work with and why?

AOGIN plans to focus on several countries in the Asia-Pacific region, particularly those with high disease burden.

Countries like India, Indonesia, and Vietnam have high cervical cancer incidence and mortality rates, making targeted interventions vital. Also, countries such as Bangladesh, Pakistan, and the Philippines exhibit substantial gaps in achieving the WHO’s screening and vaccination targets, necessitating focused efforts to improve access and awareness.

How has HPV self-sampling helped to improve screening rates?

HPV self-sampling has shown promising results in improving cervical cancer screen rates. Studies have found that self-sampling can increase screening participation rates by 20 to 50% compared to traditional clinician-collected samples. Women often prefer the convenience and privacy of self-sampling.

Also, self-sampling helps to eliminate some barriers to screening, such as fear of the clinical environment, discomfort during examinations, and stigma, leading to more women engaging in regular screening.

Based on the Position Statement and AOGIN’s upcoming plans, how can clinicians work together with AOGIN to implement cervical cancer screening into their clinical practice?

Clinicians can collaborate with AOGIN to effectively implement cervical cancer screening in several ways. They can integrate the recommendations from AOGIN’s Position Statement into clinical practice, ensuring that screening protocols align with the latest evidence and WHO guidelines. Lastly, clinicians can join AOGIN’s networks and forums to exchange knowledge, share their best practices, and collaborate with other clinicians in the region to strengthen cervical cancer prevention efforts.

The views and opinions expressed by Prof. Young-Tak Kim are his own views and opinions. Roche disclaims all liability in relation to these views and opinions.

While cervical cancer is preventable, an estimated 14,000 new cases are diagnosed in the United States every year, leading to almost 4,300 deaths from the disease.

In this recording from the 21st International Congress of Cytology (ICC), Prof Mark Stoler shows evidence that the use of HPV DNA tests as the primary form of screening, followed by using p16/Ki-67 dual staining in triage can prove effective in identifying women who are at the highest risk of cervical cancer. This testing method gives actionable results that allows clinicians and health systems to prioritise resources for those who are in need of them.

The World Health Organisation recommends HPV self-sampling to ease emotional and psychological barriers that prevent many women from pursuing screening, thus empowering women to choose the approach that works best for them. Following WHO’s recommendations, Dr Gino Venegas, while serving as Director of Cancer at the Ministry of Health in 2017, developed the National Cervical Cancer plan and implemented a HPV primary screening program. To help achieve a target of 70% screening coverage, Peru dedicated substantial resources to public education and setting up HPV testing facilities in primary care settings in both urban and rural areas.

In this recording from IPVC 2023, Dr Gino Venegas shares how Peru tackled cervical cancer by addressing numerous barriers to screening, such as lack of awareness, affordability challenges, and social stigma around HPV testing.

Since 2020, Thailand has used HPV DNA tests as a way to optimise primary screening programmes for cervical cancer. The country conducted internal studies on the cost-effectiveness of HPV tests within primary screening and found it to be economical. To increase coverage amongst the unscreened or under-screened population, self-sampling was introduced to address cultural and/or religious barriers and increase convenience for those who had routine healthcare services delayed due to Covid-19.

In this recording from AOGIN 2022, Prof Wichai Termrungruanglert of Chulalongkorn University in Bangkok, Thailand, shares how the Thai healthcare system has responded to the changing needs of the screening population. Watch the recording to find out more.

HPV screening programmes are being rolled out across many countries in a bid to eliminate cervical cancer by 2030, a target that has been set out by the World Health Organisation. As more countries gain access to innovative technology and greater experience in cervical cancer screening, some are exploring updating screening algorithms in order to improve the cost effectiveness and efficiency of existing programmes.

In this presentation recording from AOGIN 2022, Prof Tay Sun Kuie of Singapore General Hospital outlines the experience of HPV screening and detection in Singapore. Watch the recording to find out more.