Cervical Cancer and HPV

Cervical cancer caused over 340,000 deaths in women worldwide in 2020. Yet evidence produced through this stream of research has shown that cervical cancer can be eliminated as a public health problem in Australia and globally. Research by the team continues to make a significant contribution to both national and international policy development for cervical cancer control. The team’s work spans modelling, observational epidemiology, clinical trials, and data analysis to create a template for how multiple evidence-based interventions can combine to form a roadmap for a cancer free future. The team co-leads the NHMRC Centre of Research Excellence in Cervical Cancer Control (C4), the large-scale Compass trial, and is part of the COVID and Cancer Global Modelling Consortium, supporting decision makers on decisions around screening and vaccination during and after the pandemic.

Current areas of focus within this stream include:

Next horizons for cervical screening and equity in Australia

This stream of research has informed major changes to Australia’s National Cervical Screening Program with our work supporting Australia moving to a first-in-world approach to HPV-based cervical screening which interfaces with HPV vaccination by specifically testing for the presence of the HPV genotypes included in first generation vaccines. Research conducted in this stream is supporting the Australian Government Department of Health by designing and implementing safety monitoring of the changes that were made to the National Cervical Screening Program in December 2017. The team co-leads one of the largest clinical trials in the Southern Hemisphere, Compass. The aim of the study is to look at how cervical screening can be most effective in women who have been vaccinated against HPV and those who have not, and via a supplementary study, Compass-Plus, will measure the impact of primary HPV screening on aspects of psychological well-being such as anxiety and distress in women.

Building on this core work, the team is now investigating ways screening can be further optimised, particularly the management of women who are HPV-positive, new ways to tailor screening to risk for women protected by second generation HPV vaccines, and the potential role of offering more women the option of self-collection (HPV-testing on a sample collected by the patient).

In partnership with communities, the team is also contributing to work to assess the potential impact of screening strategies appropriate to Indigenous women, who are at substantially greater risk of developing cervical cancer and dying from the disease than non-Indigenous women in Australia.

Via the NHMRC C4 CRE, we are also working with collaborators to monitor and report on Australia’s progress to meeting WHO’s cervical cancer elimination targets, including in Indigenous women.

Supporting policy in Australia other high-income countries

We have a track record of supporting policy evaluation in HPV vaccination and cervical screening in several other high-income countries, including New Zealand, England, Japan and the USA. We continue to actively work with collaborators in other countries to perform evaluation of emergent cervical cancer prevention and control strategies. For example, we co-lead the CISNET-cervical consortium of modellers, funded by the US National Cancer Institute. Now in its second round of funding, as part of CISNET and with our collaborators at the University of Harvard, we recently contributed to decision-making by the US Centers for Disease Control in relation to new recommendations for adult HPV vaccination.

Via the COVID and Cancer Global Modelling Consortium, we are currently involved in multi-country evaluations of the impact of cervical screening disruptions and recovery strategies, during and after the pandemic.

Cervical cancer control strategies in low and middle-income countries

We are one of three modelling groups (others at Harvard and Universite Laval, Canada) comprising the WHO Cervical Cancer Elimination Consortium (CCEMC). Our work was presented at the Executive Board of the World Health Assembly in 2020 and is cited in the WHO strategic plan for cervical cancer elimination.  The team is now supporting the WHO in the development of updated 2021 clinical guidelines for cervical screening. In March 2021, with key C4 collaborators C4 and Minderoo Foundation announced the Eliminate Cervical Cancer in the Western Pacific (ECCWP) initiative This is a large-scale implementation and research collaboration arising from C4 research and supported by an $8.1M grant from the Minderoo Foundation.

In collaboration with international agencies and researchers, we have active work at a country level in Malaysia, China, Papua New Guinea, Vietnam, Guam and Yap, and for women living with HIV in Tanzania. Some of our recently contracted work includes working with UNFPA to develop policy briefs for 19 low and lower-middle income countries, and working with the US Centers for Disease Control and the University of Hawaii to support the implementation of HPV-based cervical screening in Guam and Yap.

Research Team

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