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HPV awareness could save thousands from cervical cancer in low-resource nations – report

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A widespread lack of awareness of how a common virus is the primary cause of cervical cancer is leading to thousands of needless deaths every year, concludes a global report.

But embracing more advanced screening tools and the willingness of more women to self-collect health data could be pivotal in addressing the issue.

That is according to a study spanning 12 countries in Europe and Latin America commissioned by the pharmaceutical giant Roche.

Half of those polled had either limited or no awareness of the important role human papillomavirus (HPV) plays in cervical cancer.

HPV is a common virus transmitted through sexual contact and is the primary cause of cervical cancer, responsible for over 99 per cent of cases.

 Every year, more than 600,000 women worldwide are diagnosed with cervical cancer and over 340,000 die, with nine in every ten of these women living in low-resource countries.

However, 93 per cent of cervical cancers could be prevented entirely through appropriate screening and HPV vaccination.

The research also demonstrates that with screening rates varying between regions, significant barriers continue to exist that are preventing women from seeking testing.

Respondents in all countries, including both developed and developing nations, reported that concerns about the testing procedure being painful were common – up to 63 per cent in some countries.

Also cited was a sense of discomfort about discussing their sexual history or sexuality with a healthcare provider – up to 57 per cent in some countries.

Joanna Sickler, vice-president, health policy and external affairs at Roche Diagnostics, said: “Thousands of women are needlessly dying from cervical cancer every year.  This survey highlights some of the most important barriers to screening, as well as the opportunities we have to prevent disease and improve women’s health.

“With many women reporting being open to new screening tools like self-collection, it has never been more important that communities, health systems, governments and innovators come together to seize this opportunity, and provide the early detection and treatment needed to avoid so many preventable deaths.”

The World Health Organisation is focused on accelerating the elimination of cervical cancer globally, with its latest guidelines recommending HPV DNA testing as primary screening for all women.

Its strategy seeks to ensure that by 2030, 90 per cent of girls are fully vaccinated against HPV by age 15.

It also aims for 70 per cent of women to have been screened using a high-performance test by age 35, and again by age 45, with 90% of those eligible linked to treatment.

This, along with vaccination against HPV, could prevent more than 62 million deaths in the next 100 years.

More than 50 per cent of new cervical cancers occur in women who have never been screened, or have not been screened in the previous five years of their lives.

Many factors can contribute to individuals not participating in cervical cancer screening programs, such as access to healthcare, social and economic barriers, history of traumatic experience, cultural concerns and embarrassment.

The many barriers preventing women from seeking HPV screening could explain the widespread interest in self-testing revealed by the survey.

In European countries, where testing is more routinely available, 57 per cent of women were interested in the opportunity to collect their own samples for testing. This figure rose to 77 per cent in Latin American countries, where routine screening is less readily available because of a lack of infrastructure and available appointment means.

This discrepancy was also reflected in healthcare professional-reported results, which showed 72 per cent of healthcare professionals and government workers in Latin American countries agree their country needs a self-collection programme, compared to 48% in Europe.

Susana Wong, patient advocate and director of Lazo Rosado, Perú, is working to expand access to HPV testing in her country.

She said: “We know very well how to prevent and treat cervical cancer. Now, with HPV molecular tests and vaccination, there really is hope to eliminate this disease. This test gives you the opportunity to live and to live well with your family. It can help women to empower themselves as to their health.”

Men demonstrated even lower levels of awareness compared to women, particularly in Europe.

While 55 per cent to 76 per cent of men in Latin America reported some understanding of HPV, only 35 per cent to 51 per cent of men in Europe had any understanding of HPV at all.

The lower awareness among men highlights the need for educational initiatives to include men, given their potential role in the transmission and prevention of HPV, says the report.

“This survey highlights both the challenges ahead and the significant opportunities we have to advance HPV prevention,” Sickler said.

“By enhancing public education about HPV risks and reimagining how we deliver care, we can drive higher screening rates and make meaningful progress in combating cervical cancer.”

Fighting cervical cancer

Screening for HPV can help identify women who are at risk of developing cervical cancer, so that the disease can be treated early before invasive cancer has a chance to develop.

In poorer countries, women are often diagnosed with cervical cancer at a more advanced stage, where the opportunity for a cure is low.

Last mont, Roche joined the Global HPV Consortium which aims to advance cervical cancer prevention efforts and raise the prominence of early screening and timely detection using high-performance HPV-DNA tests.

Conducted in Q1 2024, the HPV Health Understanding Survey involved 8,703 men and women across 12 countries.

It also measured perceptions among 2,585 healthcare professionals (HCPs) and government professionals of HPV testing availability in their own market.

Menopause

High street bakery chain Gail’s reveals menopause plan

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Gail’s has unveiled a menopause action plan offering new workplace support to thousands of staff ahead of legal reforms due in 2027.

The high street bakery chain will offer new benefits including 24/7 digital GP access and a new employee assistance programme, according to The Times.

It will also explore new online training for staff, including specific training for management.

Gail’s people director Miranda Burgum told The Times: “All we’re trying to do is talk freely and for it not to be a forbidden subject. It’s helping our managers and teams understand that this isn’t a taboo.”

“We’re going to develop the education with our managers, so it will be threaded through all our policies

“It will look at induction training, it will look at the types of people we need to make sure that we make reasonable adjustments for.

“And if somebody needs some sort of risk assessment, we’re going to be looking at [that].”

The move comes ahead of reforms due to be introduced in spring 2027 under the Employment Rights Act.

UK employers with 250 or more employees will be legally required to publish and update official menopause action plans.

The plans are intended to support employers to take effective action to improve workplace gender equality and support employees experiencing menopause.

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Fertility

Paracetamol use may impact future fertility, studies suggest

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Paracetamol use in pregnancy was not linked to autism or ADHD, while separate research found reproductive differences in girls exposed before birth.

One study analysed health records from more than 120,000 children and found no increased risk of autism following prenatal paracetamol exposure.

A separate analysis of nearly 100,000 children also found no increased risk of ADHD among those born to mothers who used the painkiller during pregnancy.

Researchers from the Hong Kong Hospital Authority examined electronic health records covering pregnancies between January 2001 and December 2023.

The autism analysis included 124,333 children, who were nine years old on average and split almost evenly between males and females. There were 3,445 autism diagnoses, representing 2.8 per cent of the group.

The ADHD analysis involved 97,285 children, who were seven years old on average and also split evenly between males and females. There were 5,168 ADHD diagnoses, representing 5.3 per cent.

Women prescribed paracetamol during pregnancy were more likely to be older and have pre-existing conditions including psychiatric disorders, as well as reasons for taking the drug such as infection, fever or chronic pain.

No association was found between prenatal paracetamol exposure and either autism or ADHD.

The findings did not differ according to the trimester in which paracetamol was taken or whether use was intermittent or daily. Advanced maternal age, defined as pregnancy in women over 35, did not alter the findings.

The researchers wrote: “Paracetamol remains a safe and essential analgesic [pain reliever] and antipyretic [fever reducer] during pregnancy, whereas alternatives, such as NSAIDs and opioids carry well-documented risks.

“Unwarranted reluctance to use paracetamol could lead to undertreatment of pain and fever, or the use of more harmful alternatives, both posing risks to the pregnancy and developing fetus.”

The authors said women should assess paracetamol use with guidance from their doctor.

A separate study involving 685 pregnant women without pre-existing conditions and 302 infant daughters found associations between prenatal paracetamol exposure and differences in reproductive organs and hormone levels.

Researchers from Copenhagen University Hospital enrolled the women during their first trimester and assessed them during the first trimester, third trimester and again when their babies were three months old.

At around three months, infants experience a temporary rise in reproductive hormones sometimes called mini-puberty.

Pregnant participants completed questionnaires every two weeks about their use of pain medicines including paracetamol. Infant girls underwent ultrasound scans of their reproductive organs and blood tests to measure hormone levels.

Researchers also examined a separate group of 1,210 girls followed from infancy to adolescence whose mothers reported paracetamol use during the third trimester.

Three-month-old girls exposed to paracetamol before birth had an average 40 per cent smaller ovarian volume, 13 per cent smaller uterine volume and 23 per cent fewer ovarian follicles.

Girls exposed during the first trimester also had lower levels of Anti-Müllerian hormone, a marker of ovarian function.

Among the older girls, those exposed before birth were more likely to have smaller uteruses at puberty and smaller ovaries during their teenage years.

Dr Margit Bistrup Fischer, lead study author and postdoctoral researcher in the Department of Growth and Reproduction at Rigshospitalet hospital in Denmark, said: “Animal studies have demonstrated that impaired formation of ovarian follicles can lead to reduced fertility and earlier reproductive aging.

“Whether the differences observed in our study have implications for fertility and age at menopause in humans remains unknown and will require long-term follow-up of the girls in our cohort.”

She cautioned that women who had used paracetamol during pregnancy “should not be alarmed by our findings”, as the study found associations rather than direct causation and outcomes for individual women and children are unclear.

“Importantly, our study does not evaluate whether [acetaminophen] causes reproductive problems, nor does it provide evidence that prenatal exposure affects future fertility or age at menopause,” she said.

“Although we observed similar associations in an independent cohort, long-term follow-up is needed to determine whether these early-life differences have any clinical significance later in life.”

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Insight

Research uncovers potential new target for breast cancer therapy

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Targeting CD1d altered immune cells slowed tumour growth and improved immunotherapy responses in mouse models of breast cancer, researchers found.

The findings suggest blocking the molecule could make the environment around breast tumours more favourable to anti-cancer immune responses.

Further work is needed to understand how these immune changes occur and how the approach could be safely used in patients.

Researchers from King’s College London, the Francis Crick Institute and University College London investigated how immune cells inside breast tumours influence cancer growth.

They focused on myeloid cells, a group of immune cells found in large numbers within tumours that can either support an immune attack against cancer or contribute to tumour growth and immune evasion.

The team examined CD1d, a molecule found on the surface of myeloid and other immune and tissue cells that helps regulate immune responses.

When CD1d was genetically removed from cells in a mouse model of breast cancer, the mice were more resistant to tumour growth. Researchers also saw changes in myeloid cell populations, including increased activity among cells that can help attack cancer.

The team then blocked CD1d using an antibody and again observed changes in myeloid cells and slower tumour growth. Blocking CD1d also improved responses to immunotherapy in the mouse model.

Researchers used single-cell RNA sequencing, a technique that examines gene activity in individual cells, to investigate the immune changes in more detail.

They identified a population of myeloid cells called monocytes that expressed genes associated with inflammation, an important part of the immune response. These cells were particularly important in restricting tumour growth in the mouse models.

A similar pattern of gene activity was identified in data from human breast cancer tumours. Its presence in myeloid cells was associated with positive responses to immunotherapy in breast cancer patients.

However, the findings in people were based on gene expression data and did not test CD1d-targeting treatment in patients.

Professor Patricia Barral, professor of immunobiology at King’s College London and senior author of the study, said: “Many breast cancers do not respond well to current immunotherapies.

“Our findings reveal a previously unrecognised mechanism by which immune cells within tumours are regulated.

“While CD1d is best known for helping immune cells recognise lipid molecules, we found that it also plays a role in shaping the behaviour of myeloid cells within tumours.

“These findings suggest that targeting the immune cells that surround and support tumours could boost anti-cancer immunity and potentially improve treatment responses in the future.”

Researchers now plan to investigate how the immune changes occur and how they can be safely harnessed in patients.

They also want to examine whether targeting CD1d could enhance existing treatments and influence treatment responses in different cancer types.

The work was supported by UKRI BBSRC, Breast Cancer Now and the Cancer Research UK City of London Centre.

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