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HUMAN PAPILLOMAVIRUS – CERVICAL CANCER – MOLECULAR POINT-OF-CARE TESTING – HIGH-RISK GENOTYPES

We aim to co-develop a molecular point-of-care test to be used in resource-poor setting and detecting 14 high-risk genotypes

01.

the brief

In 2018, over 500,000 women were diagnosed with cervical cancer, with close to 85% of the global burden occurring in developing countries. Despite being one of the most preventable cancers, over 300,000 women died from cervical cancer in 2018. Without further action to prevent or screen for cervical cancer, or to improve its treatment, a 25% increase in the number of new cases is predicted in the next 10 years. Cervical cancer is a called a ‘silent killer’: the disease develops slowly and without symptoms over a period of 10 to 15 years. This window of time offers the opportunity to detect pre-cancerous stages that can be more easily treated. Through conventional screening, i.e. taking a cervical smear or pap smear, cells of the cervix are examined under the microscope to verify for cellular changes.
Low screening coverage is an important driver of high cervical cancer incidence. In countries where organised screening programmes are poorly designed or inadequately implemented, and consequently, the proportion of under- or never-screened women is higher, cervical cancer tends to affect more women.
The main reason for poorly implemented screening programmes is that they require a high investment in medically trained staff, equipment and lab infrastructure. Moreover, while the method has proven to be successful in terms of lowering cervical cancer incidence, it needs to be repeated regularly to ensure a high detection rate. As such, sexually active women need to be screened every 3 to 5 years.

02.

our goals

The ELEVATE consortium wants to empower women to screen for their cervical cancer risk in any setting while guaranteeing rapid and easy-to-understand results. To that end, the project will identify hard-to-reach women and design a screening strategy to access them. This strategy includes the development of a user-friendly, low-cost, portable self-sampling screening tool which will be able to detect 14 high-risk human papillomavirus (HPV) types and 2 proteomic cervical cancer biomarkers.
The simultaneous detection of HPV DNA with the proteomic marker will allow for more accurate detection of HPV infections associated with cervical cancer progression. Therefore, more relevant patients can be detected and treated, thereby drastically reducing the cancer burden in these populations. An intervention during which the self-testing device will be piloted in hard-to-reach communities in Belgium, Portugal, Ecuador and Brazil will provide information about the acceptability and cost-effectiveness of the tool.

03.

our approach

To identify eligible women who do not attend cervical cancer screening (called hard-to-reach) in Belgium, Brazil, Ecuador and Portugal and to define a strategy to increase their participation. To improve the detection of high-risk HPV infections by designing a full HPV genotyping test with combined detection of cervical cancer biomarkers. To develop a portable combined genomic/proteomic testing device for the maximum user-friendliness of HPV detection and cancer development at the point-of-care in low resource settings. To determine the societal implications of the application of the developed HPV screening tool by assessing its user-acceptability and cost-effectiveness in Belgium, Brazil, Ecuador, and Portugal.

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