List of Recommendations

Now is the time for ambition. Now is the time for inspiration. Now is the time for decisive action to create an HPV cancer-free future for men and women across Europe.

 

The report sets out an evidence-based case for action on 28 recommendations on four main fronts:

  1. Universal (or ‘gender-neutral’) HPV vaccination for adolescents should be introduced along with efforts to maximise uptake.

  2. National organised population-based cervical cancer screening programmes are needed with higher levels of uptake. Screening programmes should use HPV testing technologies which are much more accurate than the traditional Pap smear.

  3. Cancer treatments must be consistently and equitably offered across all European countries in line with best practice guidelines and with care and support that maximises patients’ quality of life.

  4. Action is needed to improve public and professional awareness and education about HPV in order to improve vaccination and screening uptake and to tackle fake news head-on.


Our Central Recommendation

The European Union and the wider WHO European region should commit to the core goal of matching and exceeding the WHO Global Strategy for Cervical Cancer Elimination and implement policies and strategies for the elimination of all the cancers and diseases caused by HPV.

Related resources

See also

  • HPV Action Network
    visit
  • European Cancer Summit 2020
    visit
  • As part of an overall EU ambition for eliminating HPV cancers and diseases, Europe’s Beating Cancer Plan should encourage all EU member states to implement gender-neutral vaccination programmes. Progress towards this goal should be monitored via a European Cancer Dashboard.

  • By 2025, all European country cancer plans should include actions towards achieving population-based and gender-neutral HPV vaccination, if not already in place.

  • By 2030, gender-neutral vaccination programmes against HPV infection should be in place in all European countries.

  • The target vaccination rate by 2030 in all European countries should be at least 90% of adolescents of both genders completing the full course with particular attention paid to ensuring equitable access for all demographic groups.

  • Supplementary to gender-neutral vaccination programmes, consideration should be given to the needs of high-risk groups, including men who have sex with men, migrants and sex workers, that may otherwise fall outside of the age parameters of the universal vaccination programme.

  • Consideration should be given to extending routine vaccination programmes to older age groups on a gender-neutral basis.

  • Best practice guidance should be developed and published by the WHO and/or EU on how HPV vaccination programmes can be delivered to ensure optimal uptake.

  • In support of vaccination goals, global cooperation should be fostered, through WHO or other organisations, to resolve vaccine supply issues to ensure no country’s HPV vaccination programmes are impacted because of shortages. The EU should work with vaccine manufacturers to ensure that the supply of vaccines is sufficient in future to meet the growth in demand. Current global supply issues need not impact adversely on the timescales proposed in these recommendations.

  • Action must be taken to ensure minimum disruption to HPV vaccination programmes by COVID-19.
  • By 2025, all European country cancer plans should include actions towards achieving a minimum 70% screening target, if not already achieved.

  • By 2030, at least 70% of women in Europe should have been screened for cervical cancer with an appropriate high-precision HPV test within the last five years. This coverage should be reached, at minimum, at 35 and 45 years of age, as part of an organised population-based programme. HPV screening programmes should take into consideration innovations such as self-sampling in respect to their potential for achieving higher rates of screening, particularly during the COVID-19 pandemic.

  • In support of screening goals, EU guidelines on integrated HPV vaccination and cervical cancer screening should be regularly updated. A third edition of evidence-based guidelines should be developed by 2021/2022 to take account of recent developments in HPV testing technologies (which are now capable of identifying high-risk infections that are present and active with both high accuracy and high specificity73) and to maximise the benefits for women and health professionals.

  • More research is needed into improving the early detection of non-cervical cancers caused by HPV. This effort should be supported under the aegis of the EU Cancer Mission and Horizon Europe research programme.

  • Progress on improving and widening access to HPV testing should be monitored by a European Cancer Dashboard.
  • By 2030, across all European countries, a minimum of 90% of women with Grade 3 cervical pre-cancer should be treated within three months; and a minimum of 90% of all invasive cervical cancer cases should have been detected and managed.

  • By 2025, all European country cancer plans should include actions to achieve these cervical cancer treatment goals, if not already achieved. They should also contain actions to implement best practice guidelines for non-cervical cancers caused by HPV.

  • All country cancer plans should ensure that quality of life issues are fully addressed.

  • A European Cancer Dashboard, operating as part of the monitoring and implementation element of Europe’s Beating Cancer Plan, should provide regular publicly available updates on the progress being made towards these goals.
  • By 2025 all European country cancer plans should include actions to increase public, patient and healthcare professional understanding and awareness about HPV. This awareness should include the range of related cancers and diseases, their symptoms and forms of prevention. Furthermore, this communication effort should elaborate to the public, patients and healthcare professionals the potential and need for HPV elimination, the strategies being pursued to achieve that goal, and the role of the public, patients and healthcare professionals. Awareness levels of the public, patients and healthcare professionals on HPV should be thereafter be monitored and reported on.

  •  These awareness raising actions should encompass the dental workforce, the schooling system, community pharmacists and nurses as well as physicians in primary and secondary care.

  •  By 2021, cancer societies, patient and healthcare professional associations, and other stakeholders, should publish a core list of consensus recommendations for European member states to implement in order to combat the impacts on HPV vaccination uptake posed by fake news.

  • By 2021, all major social media platforms operating in Europe should have developed and implemented effective strategies that build on already-implemented measures to reduce significantly further the spread of fake news on vaccination.

  • By the end of 2022, all national cancer plans in Europe should include actions to combat the deterrence effects of fake news upon HPV vaccination rates, as part of a broader campaign to reduce the negative impact of fake news on all vaccination programmes.

  • By 2025, all European countries should have accountable population-based registries in place to track and report on HPV vaccination, HPV screening and HPV related (and other) cancer incidence, survival and mortality data.

  • ECDC should be given the authority to oversee the implementation of an EU goal to eliminate cancers caused by HPV.

  • By 2021, the EU Cancer Mission should have clear elements within its programme that support the WHO global strategy for the elimination of cervical cancer as a public health problem and the European Cancer Organisation 2019 European Cancer Summit resolution on the elimination of cancers caused by HPV. This should include supporting research priorities such as new vaccine and screening technologies as well as care and treatment modalities. Research is also needed into the vaccination of women found to be HPV-positive at cervical cancer screening as a way of interrupting the transmission of the virus into the community.

  • EU Cancer Mission goals, such as on HPV, should be complemented by an EU Cancer Masterplan that supports achievement in respect to non-research-related matters. This might include facilitating greater use of EU structural funds to achieve EU- and WHO Europe-wide HPV vaccination, cervical cancer screening, and treatment goals for HPV-related cancers.

  • As part of the coordination role that the EU should play in assisting member states to combat cancer by 2025, a public monitoring and reporting exercise should be established in respect of EU Member State cancer plans, similar to ‘the State of Health in the EU’ exercise. This should include the monitoring of actions towards goals on HPV-related cancer elimination. Such a mechanism could be developed within the context of the European Cancer Dashboard suggested within the European Parliament Research Service Report ‘Strengthening Europe in the Fight Against Cancer’.97