(updated 10 July 2023)
Today (Wednesday 5 July), the World Health Organization’s International Agency for Research on Cancer (IARC) met with the HSE National Screening Service and the Department of Health to launch a new report on best practice recommendations for the international cervical screening community.
A forum, led by representatives from IARC, was held in the Royal Irish Academy in Dublin with Irish partners, project stakeholders and international academics to discuss the best practice guidance.
The recommendations come from the completion of the CervScreen project, a joint initiative of IARC, the HSE and the Department of Health, that aims to address global issues relating to the quality and coverage of cervical screening programmes.
In a press release IARC said “Well-organised screening programmes have been shown to reduce the incidence and mortality rates of cervical cancer in populations. The development of best practices for cervical screening programmes is critical to ensure that these programmes are effective, efficient, and safe for all participants.”
Welcoming IARC to Dublin, our Chief Executive Fiona Murphy, said “Participating in the CervScreen collaboration has given the National Screening Service the opportunity to reflect on the important areas outlined in the report and gain access to relevant international experts, as well as the expertise of the IARC team.”
Three Technical Working Groups were formed as part of the initiative, and experts from 14 different countries were involved in developing the advice, comprising global experts in the areas of public health, implementation and quality improvement of cancer screening, health communication, national and international laws governing relevant medicolegal issues, and regulations in data protection.
In 2022, a cervical screening stakeholders discussion forum was organised by IARC in Dublin. The forum included a number of patient representatives, where stakeholder views were presented to the working group chairs for consideration as they developed their recommendations.
“We were delighted to be able to widen out the work of creating this report to our stakeholders” Fiona said, “and grateful that the views and experiences of our stakeholders have gone on to create a report that will influence best practice in screening programmes internationally.”
The report covers several recommendations including conducting an audit of cervical cancers, establishing legal and ethical frameworks, and developing strategies for effective communications with target populations and other stakeholders.
Emphasising the importance of conducting regular audit of cervical cancers, the report clearly outlines audit as a quality improvement measure rather than a tool to investigate perceived lapses. It also confirms that there is no legal or ethical consensus internationally on audits, recommending that processes be put in place – legislative or otherwise – to reflect the inherent limitations in cancer screening.
The report endorses Ireland’s approach to offering personalised reviews to women who have had a cancer diagnosis and have come for screening in the past. “This is a new development for our cervical screening programme” Fiona remarked, “and it’s exciting to see it captured as a recommendation for screening programmes internationally. Our new personal cervical screening reviews take a restorative approach, answering women’s questions around their screening journey. It will be important to evaluate our review process as the first women begin to go through the process this year.”
The report outlines that effective communication to all women is a crucial element of cervical screening programmes, and provides recommendations to ensure that communication is transparent, understandable, and culturally appropriate. It also recognises the need to build workforce competencies in communication to ensure that all women receive the information and support they need to make informed decisions about their health.
Fiona added “Since 2020 we have been working to focus our approach on communicating the benefits, harms and limitations of population screening equally and in an equitable way – providing clear information about the potential positive and negative effects of screening, and conveying the fact that screening is a personal choice.”
Launching the report, Director of IARC, Dr Elisabete Weiderpass said: “I believe that this best practice document will provide a valuable resource for practitioners and researchers working in cervical screening programmes all around the world and will help to ensure that these programmes operate in a safe and effective manner, and to support the WHO Global Initiative on the elimination of cervical cancer.”
Concluding, Fiona said: “We will be guided by the IARC recommendations as we continue to build long-lasting trust in our cervical screening programme, respecting the autonomy in decision-making by every screening participant.”
Today’s discussion marks the closing meeting for the CervScreen project.