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Published: 15 May 2023

Trending topics in a New Era for Colposcopy Services

By Susan Donlon, Communications Team, National Screening Service

The sweltering 22-degree heat did nothing to curb the enthusiasm of the 130+ delegation at the CervicalCheck 2023 Annual Colposcopy Conference on the banks of the River Shannon in Athlone on Friday, 12 May 2023.

Welcoming everyone to the conference on what was also International Nurses Day, our Chief Executive Fiona Murphy paid tribute “to all our nursing colleagues in screening who support our participants every day with care and compassion”.

In his opening address, Chief Clinical Officer of the HSE, Dr Colm Henry addressed the effects of the Covid-19 pandemic on cancer screening and applauded the resilience of the CervicalCheck team over the past few years, thanking them for their passion and commitment, adding “you have my full support behind this programme”.

In the first presentation of the day, Clinical Director of CervicalCheck, Professor Nóirin Russell, gave an update on the programme and encouraged everyone who provides a cervical screening service to support each other to build and strengthen trust and confidence in the programme. Prof Russell spoke about our national and international collaboration with the Department of Health and the World Health Organization International Agency for Research on Cancer (IARC) to prepare strategic guidance on best practice related to cervical cancer screening. In the coming weeks IARC will publish a final report outlining globally relevant best practice guidelines on audit, communication and the legal environment.

Dr Cliona Murphy, Clinical Director with the National Women and Infant Health Programme presented on future plans for the delivery of gynaecology services, improving access to care and shared priority collaborations with CervicalCheck to give women the best quality of care. From Letterkenny University Hospital, candidate Advanced Nurse Practitioner in Women’s Health, Charlene Bogan, gave an inspirational talk about the important role of nurse colposcopists who can manage whole episodes of care and provide support to other team members in colposcopy and gynaecological clinics.

The first international speaker of the day, Dr Jesper Bonde, a senior researcher with the Department of Pathology, Hvidore in Denmark, presented the Danish experience of managing women with persistent HPV infection but no disease, in an HPV screening programme. Presenting on disease burden, HPV prevalence and the Danish roadmap towards Cervical Cancer Elimination, Dr Bonde emphasised the need for screening in parallel with HPV vaccination until the majority female population are vaccinated.

Data modelling for future colposcopy activity was presented by our own Business Intelligence Analyst Micheál Rourke, explaining how modelling can assist CervicalCheck to predict how many women will attend for screening tests and onward to colposcopy as necessary, enabling planning of sustainable services and ensuring the needs of screening participants are met.

Closing off the session before the mid-day break, Professor Grainne Flannelly spoke passionately about the importance of education for colposcopists of the future. Outlining the key topics and competencies involved to provide a patient-centred service, Prof Flannelly highlighted the collaborative work with our colleagues in IARC to develop support for colposcopy education and called for more nurses who want to extend their practice to become specialised in colposcopy and ensure the continuum of a highly-qualified sustainable workforce in the speciality in Ireland.

Poster Presentations

There were 18 posters presented at the conference on various surveys, research and projects relating to cervical screening, HPV, colposcopy, interval cancer and cervical self-sampling, among others. Prizes were awarded to two posters: The Cervical One Stop Assessment Clinic, Cork University Maternity Hospital, describing how the clinics ensure sufficient colposcopy capacity for screened positive women while also ensuring that women with cervical gynaecological symptoms have timely access to appropriate care; and Donegal Sexual Assault Treatment Unit for a poster detailing the cervical screening opportunities for women who have experienced sexual violence, in a trauma-informed, non-judgemental, and safe environment.

Future challenges in cervical screening

The final session of the conference, chaired by Dr John Price, Colposcopy Advisor with CervicalCheck, began with our second international speaker of the day, Dr Matejka Rebolj. A senior researcher with the cancer prevention group at Kings College London, Dr Rebolj gave a thought-provoking presentation on the value of including HPV self-sampling in screening, highlighting that what we most often hear is “the good news”. Talking us through the pros and cons of cervical self-sampling for HPV, Dr Rebolj emphasised that self-sampling is likely to benefit underscreened women but may result in people switching from one sampling method to another. While HPV self-sampling can be a useful and (cost-) effective test, the advice from Dr Rebolj when considering self-sampling in cervical screening is that it will be more complex than anticipated, to “make haste slowly” and crucially, to ensure transparent and robust communications about the benefits, harms and limitations of this sampling method.

Two further presentations followed from Dr Judi Lynch, Clinical Microbiologist at The Coombe Hospital who presented on screening after hysterectomy, and Aidin Roberts, Clinical Nurse Specialist with the Survivorship Cervical Cancer Clinic at UCD, who presented on survivorship after cervical cancer. The latter included a recorded interview with Ciara, a powerful patient advocate sharing her story about the reality and impact of living with cervical cancer.

Our final speaker of the day was our Director of Public Health, Dr Caroline Mason Mohan, who presented on our partnership work to eliminate cervical cancer in Ireland. The presentation highlighted the success of the CervicalCheck screening programme in reducing the incidence of, and mortality rates from, cervical cancer, published in a report by the National Cancer Registry Ireland. Speaking about the importance of the HPV vaccination programme in reaching global targets to eliminate cervical cancer, Dr Mason Mohan paid tribute to the late Laura Brennan for her support in helping to turn around uptake of the vaccine.

Closing off the conference with a Q&A session, one final question was put to Dr Mason Mohan: “Can Ireland reach the global targets by 2030 to put us on a path to Cervical Cancer Elimination?” The answer “Yes we can” was met with rapturous applause, and it seemed fitting that the conference was a trending topic in Ireland on the day.