Cervical cancer is a major global health problem. It ranks as the fourth most common cause of cancer-related deaths among women, despite the disease being largely preventable. Now, researchers from Karolinska Institutet have received funding from the UICC to investigate how an HPV self-screening programme can be implemented in war-torn Ukraine.
The primary cause of cervical cancer is human papillomavirus (HPV), and effective cancer prevention programs are therefore based on HPV screening and vaccination.
In a collaboration between researchers from Karolinska Institutet and Zaporizhzhia State Medical University in Ukraine, a new study will help to develop a programme for self-sampling for HPV testing in the city of Zaporizhzhia, located in eastern Ukraine about 35 km from the war zone.
The two-year project "Human papillomavirus self-sampling for enhancing cervical screening during the war in Ukraine" has been granted 235 980 Euros through the Reimagining Cancer Research in Europe Initiative, administered by the Union for International Cancer Control (UICC).
UICC aims to leverage the potential of cancer prevention to reduce the growing burden of cancer in Europe.
"Whilst Sweden has a well-established HPV screening program, other countries do not. One such country is Ukraine, where a pilot project for HPV screening was initiated but unfortunately halted due to the beginning of the armed conflict in the country," says Sara Arroyo Mühr, research coordinator at the Center for Cervical Cancer Elimination, the Department of Clinical Science, Intervention and Technology at KI. "Our project aims to reignite the previous efforts and build upon the groundwork laid down by the pilot project."
An urgent need for innovative approaches
One of many challenges during crises and armed conflicts is that the healthcare system is often disrupted. Immediate and pressing medical needs are prioritised, and preventive measures often become secondary.
"There is an urgent need to adapt existing strategies and develop innovative approaches to address the health challenges these situations present. The use of self-sampling circumvents the need for frequent visits to healthcare facilities, making it particularly well-suited for regions where access to traditional screening methods may be limited or compromised," says Sara Arroyo Mühr.
Drawing on Swedish expertise
The project will initially undertake quality assurance of the Ukrainian HPV screening test, provide self-sampling kits, develop a centralised database, protocols, and procedures, as well as setting up a training programme for healthcare practitioners.
Once the setup is in place, women within the ages of 30 and 60 will be offered self-sampling for HPV.
"Drawing upon Swedish success and expertise, we will measure key implementation outcomes such as acceptability, adoption, feasibility, cost and sustainability. In addition, a process evaluation will provide insights into the practicalities of implementing an HPV screening intervention in a conflict setting," says Sara Arroyo Mühr.
The goal is to create a basis for a sustainable and effective cervical cancer screening programme in Zaporizhzhia, and in the long run establish national HPV screening in the whole of Ukraine.
"Through the support of this grant, we hope to make a tangible impact on the lives of women in Zaporizhzhia, while the knowledge may support on-going global efforts in combatting cervical cancer," concludes Sara Arroyo Mühr.
