Increasing global accessibility to high-level treatments for cervical cancers

C. Chargari; M. Arbyn; A. Leary; N. R. Abu-Rustum; P. Basu; F. Bray; S. Chopra; R. Nout; K. Tanderup; A. N. Viswanathan; C. Zacharopoulou; J. C. Soria; E. Deutsch; S. Gouy; P. Morice

doi:10.1016/j.ygyno.2021.10.073

Increasing global accessibility to high-level treatments for cervical cancers

C. Chargari^*
, M. Arbyn
, A. Leary
, N. R. Abu-Rustum
, P. Basu
, F. Bray
, S. Chopra
, R. Nout
, K. Tanderup
, A. N. Viswanathan
, C. Zacharopoulou
, J. C. Soria
, E. Deutsch
, S. Gouy
, P. Morice

^*Corresponding author for this work

Radiotherapy

Institut Gustave Roussy
Université Paris-Saclay
Unit Cancer Epidemiology – Belgian Cancer Centre
Memorial Sloan-Kettering Cancer Center
European Society of Gynecological Oncology
International Agency for Research on Cancer
International Agency for Research on Cancer
Homi Bhabha National Institute
Aarhus University Hospital
Johns Hopkins School of Medicine
Committee on the Environment

Research output: Contribution to journal › Review article › Academic › peer-review

33 Citations (Scopus)

Abstract

Human papillomaviruses (HPV)-related gynecological cancers are a major health care issue, and a leading cause of cancer death in low- and middle-income countries (LMIC). In 2020, the World Health Organization launched a program aimed at cervical cancer elimination, by screening and vaccination strategies. Offering the best possible care to women diagnosed with invasive cancer is a complementary objective. Treatment of cervical cancer as per modern standards is complex and multimodal, mainly relying on surgery, external-beam radiotherapy (+/−chemotherapy) and brachytherapy. In parallel with the pivotal role of multidisciplinary discussion, international societies provide guidance to define the most effective and least toxic anti-cancer strategy, homogenize treatment protocols and provide benchmark quality indicators as a basis for accreditation processes. The challenge is to offer the appropriate diagnostic workup and treatment upfront and to avoid non- evidence-based treatment that consumes resources, impairs quality of life (QoL), and compromises oncological outcome. Various strategies may be applied for improving treatment quality: development of surgical mentorship, companion-training programs and international cooperation. The lack of radiotherapy/brachytherapy facilities is a major concern in LMIC. Reinforcing international support in terms of education, training, research and development and technical cooperation with national projects is required to increase access to minimum requirements but also introduce modern techniques, upgrade radiotherapy/brachytherapy services, and expand access to modern systemic treatments. In countries with robust economies, compliance to standards should also be increased. Integrative cancer care and multidisciplinary approaches are needed to tackle the dual challenge of increasing cure rates while minimizing QoL impairment. Appropriate dimensioning of the resources to avoid harmful treatment delays and access to expert referral centers is also a priority.

Original language	English
Pages (from-to)	231-241
Number of pages	11
Journal	Gynecologic Oncology
Volume	164
Issue number	1
Early online date	26 Oct 2021
DOIs	https://doi.org/10.1016/j.ygyno.2021.10.073
Publication status	Published - 1 Jan 2022

Bibliographical note

Funding Information:
CC reports personal fees and nonfinancial support outside from the submitted work from GSK and MSD, service as an investigator for clinical trials sponsored by Roche, non financial support for clinical research from TherAguix; AL reports support for clinical trials, advisory Board and travel to congress from Tesaro, Astrazeneca, Clovis, GSK, advisory board from Zentalis and Biocad, support for clinical trial and advosiry board from Ability, advisory board from Merck Serono with institutional fees, advisory board from Seattle Genetics. ED reports grants and personal fees from Roche Genentech, grants from Servier, grants from AstraZeneca, grants and personal fees from Merck Serono, grants from BMS, and grants from MSD. JCS is full time employee at Amgen since August 2 nd 2021 and declares shares from Gritstone bio and Relay Therapeutics. SC reports research funding from Varian. MA reports funding received by Sciensano. AV is editor-in-chief, Seminars in Radiation Oncology and chair of the Uterine Cancer Task force for the National Cancer Institute. bu-Rustum reports grants from Stryker/Novadaq, grants from GRAIL, outside the submitted work; NAR reports grants from Stryker/Novadaq, grants from GRAIL, outside the submitted work; Other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Funding Information:
MA was supported by the European Society of Gynecological Oncology ; the Horizon 2020 Framework Programme for Research and Innovation of the European Commission , through the RISCC Network (grant no. 847845 ); and Belgian Foundation Against Cancer through the IHUVAC project .

Publisher Copyright:
© 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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10.1016/j.ygyno.2021.10.073

Cite this

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title = "Increasing global accessibility to high-level treatments for cervical cancers",

abstract = "Human papillomaviruses (HPV)-related gynecological cancers are a major health care issue, and a leading cause of cancer death in low- and middle-income countries (LMIC). In 2020, the World Health Organization launched a program aimed at cervical cancer elimination, by screening and vaccination strategies. Offering the best possible care to women diagnosed with invasive cancer is a complementary objective. Treatment of cervical cancer as per modern standards is complex and multimodal, mainly relying on surgery, external-beam radiotherapy (+/−chemotherapy) and brachytherapy. In parallel with the pivotal role of multidisciplinary discussion, international societies provide guidance to define the most effective and least toxic anti-cancer strategy, homogenize treatment protocols and provide benchmark quality indicators as a basis for accreditation processes. The challenge is to offer the appropriate diagnostic workup and treatment upfront and to avoid non- evidence-based treatment that consumes resources, impairs quality of life (QoL), and compromises oncological outcome. Various strategies may be applied for improving treatment quality: development of surgical mentorship, companion-training programs and international cooperation. The lack of radiotherapy/brachytherapy facilities is a major concern in LMIC. Reinforcing international support in terms of education, training, research and development and technical cooperation with national projects is required to increase access to minimum requirements but also introduce modern techniques, upgrade radiotherapy/brachytherapy services, and expand access to modern systemic treatments. In countries with robust economies, compliance to standards should also be increased. Integrative cancer care and multidisciplinary approaches are needed to tackle the dual challenge of increasing cure rates while minimizing QoL impairment. Appropriate dimensioning of the resources to avoid harmful treatment delays and access to expert referral centers is also a priority.",

author = "C. Chargari and M. Arbyn and A. Leary and Abu-Rustum, \{N. R.\} and P. Basu and F. Bray and S. Chopra and R. Nout and K. Tanderup and Viswanathan, \{A. N.\} and C. Zacharopoulou and Soria, \{J. C.\} and E. Deutsch and S. Gouy and P. Morice",

note = "Funding Information: CC reports personal fees and nonfinancial support outside from the submitted work from GSK and MSD, service as an investigator for clinical trials sponsored by Roche, non financial support for clinical research from TherAguix; AL reports support for clinical trials, advisory Board and travel to congress from Tesaro, Astrazeneca, Clovis, GSK, advisory board from Zentalis and Biocad, support for clinical trial and advosiry board from Ability, advisory board from Merck Serono with institutional fees, advisory board from Seattle Genetics. ED reports grants and personal fees from Roche Genentech, grants from Servier, grants from AstraZeneca, grants and personal fees from Merck Serono, grants from BMS, and grants from MSD. JCS is full time employee at Amgen since August 2 nd 2021 and declares shares from Gritstone bio and Relay Therapeutics. SC reports research funding from Varian. MA reports funding received by Sciensano. AV is editor-in-chief, Seminars in Radiation Oncology and chair of the Uterine Cancer Task force for the National Cancer Institute. bu-Rustum reports grants from Stryker/Novadaq, grants from GRAIL, outside the submitted work; NAR reports grants from Stryker/Novadaq, grants from GRAIL, outside the submitted work; Other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Funding Information: MA was supported by the European Society of Gynecological Oncology ; the Horizon 2020 Framework Programme for Research and Innovation of the European Commission , through the RISCC Network (grant no. 847845 ); and Belgian Foundation Against Cancer through the IHUVAC project . Publisher Copyright: {\textcopyright} 2021",

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AU - Bray, F.

AU - Chopra, S.

AU - Nout, R.

AU - Tanderup, K.

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N2 - Human papillomaviruses (HPV)-related gynecological cancers are a major health care issue, and a leading cause of cancer death in low- and middle-income countries (LMIC). In 2020, the World Health Organization launched a program aimed at cervical cancer elimination, by screening and vaccination strategies. Offering the best possible care to women diagnosed with invasive cancer is a complementary objective. Treatment of cervical cancer as per modern standards is complex and multimodal, mainly relying on surgery, external-beam radiotherapy (+/−chemotherapy) and brachytherapy. In parallel with the pivotal role of multidisciplinary discussion, international societies provide guidance to define the most effective and least toxic anti-cancer strategy, homogenize treatment protocols and provide benchmark quality indicators as a basis for accreditation processes. The challenge is to offer the appropriate diagnostic workup and treatment upfront and to avoid non- evidence-based treatment that consumes resources, impairs quality of life (QoL), and compromises oncological outcome. Various strategies may be applied for improving treatment quality: development of surgical mentorship, companion-training programs and international cooperation. The lack of radiotherapy/brachytherapy facilities is a major concern in LMIC. Reinforcing international support in terms of education, training, research and development and technical cooperation with national projects is required to increase access to minimum requirements but also introduce modern techniques, upgrade radiotherapy/brachytherapy services, and expand access to modern systemic treatments. In countries with robust economies, compliance to standards should also be increased. Integrative cancer care and multidisciplinary approaches are needed to tackle the dual challenge of increasing cure rates while minimizing QoL impairment. Appropriate dimensioning of the resources to avoid harmful treatment delays and access to expert referral centers is also a priority.

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Increasing global accessibility to high-level treatments for cervical cancers

Abstract

Bibliographical note

UN SDGs

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