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.
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.