Cervical cancer is third most common cancer among women worldwide and human papillomavirus (HPV) is the cause of almost all cervical cancer cases. Cervical cancer screening programs aim to decrease the incidence and mortality from cervical cancer. However, participation in screening programs needs to be improved.

The IMPROVE trial

The IMPROVE trial, led by a multidisciplinary team of Cancer Center Amsterdam researchers, was launched to test implementation of self-sampling for cervical screening in the Netherlands. In this randomized, non-inferiority study, women aged 29-61 years were invited to participate as part of their regular screening invitation. Participants were assigned randomly to either a self-sampling group or a clinician-based sampling group. In results recently published in Lancet Oncology, the researchers showed that HPV testing had similar accuracy on self-collected and clinician-collected samples, meaning it could be used as a primary screening method in routine screening (Polman et al. Lancet Oncology, 2019).

Reaching more women

The self-sampling approach will reduce the burden on screening programs and clinics. Importantly, it may increase uptake of screening by women who might otherwise skip clinic visits. Offering a choice of self-collection or clinician-collection of cervical samples will likely reach a larger population of women at risk for HPV and cervical cancer. In a related publication in the journal Preventative Medicine, the IMPROVE trial also found that the majority of women in the study preferred self-sampling (76.5%) to clinician-based sampling (11.9%) in future screening. This choice has now been implemented in the Dutch cervical screening program.

HPV research

The HPV research group at Cancer Center Amsterdam, which has a more than 25-year research track record in HPV and cervical screening, are developing novel molecular tests and screening algorithms for the fight against cervical cancer.

Further cervical cancer screening improvements, such as a molecular triage test for HPV-positive women, are currently ongoing. These novel insights are being extended to clinical applications for other HPV-induced (pre)cancers.

Researchers involved

Maaike Bleeker