UNC researchers in cervical cancer prevention, members of the Institute for Global Health and Infectious Diseases and Lineberger Comprehensive Cancer Center, filled the agenda at a recent scientific session for the EUROGIN International Multidisciplinary HPV Conference in Stockholm, Sweden.
EUROGIN’s U.S. Chair Jennifer S. Smith, PhD, professor of epidemiology at the UNC Gillings School of Global Public Health was invited to lead “Cervical Cancer Screening in LMICs,” which largely included global health researchers from UNC-Chapel Hill. Smith says it was an opportunity to highlight ongoing collaborations aimed at eliminating cervical cancer globally across UNC schools, departments and global studies.
“Novel implementation research is critical to identifying optimal ways to increase screening coverage and to ensure that all women with screen positive results obtain necessary follow-up care,” said Smith, who has conducted research on HPV infection and associated cervical neoplasia and cancer since 1995, and published over 350 articles in international peer-reviewed journals.
“To achieve the World Health Organization’s 90/70/90 Cervical Cancer Elimination target, innovative and resource-appropriate strategies are needed to improve cervical precancer treatment among women globally. It was an exciting session. UNC researchers presented a variety of innovations that offer promising solutions.”
Highlights From the Scientific Session
Single visit screen-and-treat strategy with Xpert-based HPV self-testing and thermal ablation treatment for women in Lilongwe, Malawi was presented by Lameck Chinula, MD, associate professor in the UNC Department of Obstetrics and Gynecology’s Division of Global Women’s Health. This study evaluated the same-day completion of a GeneXpert-based HPV self-testing screen-triage-treat algorithm for cervical cancer prevention among women living with HIV (WLWH) and women without HIV. It showed Xpert testing, and HPV self-sampling offer a promising platform for a single-visit approach to cervical cancer screening in sub-Saharan Africa and similar settings.
Feasibility of topical, self-administered therapy for HPV/cervical precancer treatment in LMICs was presented by Chemtai Mungo, MD, MPH, FACOG, assistant professor in the UNC Department of Obstetrics and Gynecology’s Division of Global Women’s Health. Mungo’s team is conducting a pilot study investigating the feasibility of using 5-Fluorouracil as an adjuvant, self-administered intravaginal therapy following cervical intraepithelial neoplasia grade 2/3 (CIN2/3) treatment among twelve WLWH in Kenya (ClinicalTrials.gov NCT05362955).
A generosity-based Intervention Strategy to Increase Service Uptake for Cervical Cancer Prevention in China was presented by Dan Wu, MBBS, MSc, PhD, (Nanjing Medical University), collaborating with Joe Tucker, MD, PhD, Weiming Tang, PhD, and Jennifer S. Smith, PhD, MPH.
Crowdsourcing HPV Screening and Vaccination Strategies for Mothers and Daughters in Nigeria: Findings from a Community-Led Participatory Event was presented by Juliet Iwelunmor, PhD, (Washington School of Medicine in St. Louis) with UNC collaborators Joe Tucker, MD, PhD, and Jennifer S. Smith, PhD, MPH.
Screening in LMIC: Moving towards the HPV-Automated Visual Evaluation (PAVE) strategy in nine countries was presented by Silvia de San Jose, MD (Barcelona Institute for Global Health), collaborating with Jennifer S. Smith, PhD, in El Salvador. The HPV-automated visual evaluation (PAVE) Study is an extensive, multinational initiative designed to advance cervical cancer prevention in resource-constrained regions. PAVE aims to assess a novel screening-triage-treatment strategy integrating self-sampled HPV testing, deep-learning-based automated visual evaluation, and targeted therapies.
HPV self-collection in low-and-middle income countries: prevention potential and logistical issues for implementation was presented by Jennifer S. Smith, PhD, including updates on the promise and challenges of implementing HPV self-collection programs globally.
The role of digital tools in cervical cancer screening in low resource settings: experiences from Uganda was presented by John Kabukye, PhD, (Stockholm University), the only non-UNC affiliated researcher in the scientific session. His recent work considers smartphone-based telemedicine for cervical cancer screening in Uganda.
EUROGIN is an annual event that shares translational research with an international scientific community aimed at accelerating the reduction of the burden of HPV-related cancers and their mortality. The next meeting will be held in Porto (Portugal) on March 16-19, 2025.