Resolution on HPV-Related Cancer Elimination

12 September 2019

Developed together with several the European Cancer Organisation's member societies and a large network of interested organisations and experts, and including a public consultation period, the resolution on HPV elimination reads:

'By 2030, effective strategies to eliminate cancers caused by HPV as a public health problem should be implemented in all European countries.'

 

The resolution was passed during the 2019 European Cancer Summit.

 

Proposed Actions and Measures to be Taken to Support Achievement of the Resolution

The following draft action plan was subject to public consultation during the summer of 2019 and will be further developed and published in light of the responses received.
 

Proposed Actions and Measures to Be Taken to Support Achievement of the Resolution on HPV Elimination

These Actions will be further described and articulated in a position paper to be developed between the European Society of Gynaecological Oncology (ESGO), European Network of Gynaecological Cancer Advocacy Groups (ENGAGe), the European CanCer Organisation (ECCO) and others following the ECCO 2019 European Cancer Summit.
 
Comments on the recommended actions are invited before the ECCO 2019 European Cancer Summit.
 

Actions on HPV Vaccination

  • 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 the 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 for both genders.
 
In support of vaccination 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 2022.
 
Supplementary to gender-neutral vaccination programmes, consideration should be given to the needs of high risk groups that may otherwise fall outside of the age parameters of the universal vaccination programme.
In support of vaccination goals, global cooperation should be fostered, through WHO or other agents, to resolve vaccine supply chain issues to ensure no country’s HPV vaccination programmes are impacted because of shortage.
 
To see also the position paper of the European Society of Gynaecologic Oncology (ESGO) and the European Federation for Colposcopy (EFC) on Human papillomavirus vaccination, May 2019, for further information and recommendations in this area.
 

Actions on Screening & Early Diagnosis

  • 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 5 years. This coverage should be reached, at minimum, at 35 and 45 years of age, as part of an organised programme*. HPV screening programmes should take into consideration innovations such as self-sampling in respect to their potential for achieving higher rates of screening.
  • By 2025, all European country cancer plans should include actions towards achieving the 70% screening target, if not already achieved.
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 2022.
* For further information on these screening target rates, see the proposed WHO strategy for cervical cancer elimination
 

Actions on Treatment

  • By 2030, across all European countries, 90% of women with Grade 3 cervical intraepitheal neoplasia should be treated within 3 months; and 90% of all invasive cancer cases should have been detected and managed*.
  • By 2025, all European country cancer plans should include actions towards achieving these treatment goals if not already achieved
* For further information on these treatment target rates, see the proposed WHO strategy for cervical cancer elimination
 

Further Actions to Support the Achievement of the Summit HPV Resolution

 

HPV Awareness
  • By 2025 all European country cancer plans should include actions towards increasing 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 to achieve the elimination goal. 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 in respect to oropharyngeal cancer, and the schooling system.

Combating the impact of Fake News on Vaccination
  • 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 strategies to reduce 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.

Improving data and monitoring
  • By 2025, all European countries should have population based registries in place to accountably track and report upon HPV vaccination, HPV screening and HPV related (and other) cancer incidence and mortality data.

EU Cancer Mission
  • By 2021 the EU Cancer Mission should have clear elements within its programme that are supportive to the WHO global strategy for the elimination of cervical cancer as a public health problem, and the ECCO 2019 European Cancer Summit resolutions on elimination of HPV.

This should include supporting research priorities such as new vaccine and screening technologies as well as care and treatment techniques.

Complementing the EU Cancer Mission with an EU Cancer Masterplan
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 wide HPV vaccination, cervical cancer screening, and treatment goals for HPV related cancers.
 
Monitoring of Member State Cancer Plans
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 to EU member state cancer plan items, similar to ‘the State of Health in the EU’ exercise. This should include monitoring of actions towards international goals on HPV related cancer elimination. 
 

A further set of actions accompanying the resolution will continue to be developed with stakeholders following the ECCO 2019 European Cancer Summit.

For further information about the resolution and action plan, and how you and/or your organisation can get involved in the campaign to follow, please contact summit@europeancancer.org.