EUROGIN 2024 – key takeaway messages

By Rebecca Millecamps, Fujirebio

The annual EUROGIN conference covers a dense scientific program on the topic of Human papillomavirus (HPV) and its associated cancers, always with a strong focus on the patient. This year’s edition in Stockholm, Sweden was no exception. Bringing together attendees from all over the world, EUROGIN 2024 offered a global perspective on the current challenges and successes in prevention, diagnosis and treatment of high-grade precancerous lesions, cervical cancer, and other HPV-related diseases. In this article we review what we see as the key takeaway messages of the conference.

Towards more effective and efficient cervical cancer screening in Europe

The burden and control of cervical cancer is changing a lot. About 70 percent of the European population has access to an organized screening program, however cervical cancer is still common.  Screening would be more effective and efficient by directing screening resource to those most at risk.  Most screening programs today report unnecessary colposcopy referrals of about 80 to 90 percent. Risk-based screening will be increasingly important in a future mixed population of highly vaccinated young people and older non-vaccinated population, with high variance in cancer risk. The implementation of a risk-based cervical cancer screening is being evaluated and a European consortium, the Risk-based Screening for Cervical Cancer (RISCC), aims to develop and implement risk-based HPV screening strategies.  

Cervical cancer screening programmes are evolving rapidly with the introduction of new technologies and with the arrival of vaccinated women in screening programs.  What will be the role of cytology in the coming years?  It has already changed from primary screening test to triage test to increase the specificity of HPV testing.  The HPV screening protocols are evolving further towards molecular testing to detect those at high risk of progression. 

With the implementation of self-collected samples, the increased use of HPV genotyping and interest in point-of-care tests, more extended principles and concepts are needed for the validation of HPV tests for primary screening.  HPV-type specific performance, ranking of HPV genotypes, impact of storage/transport media or collection methods and devices used, are all topics of concern and are widely debated as is also reflected in the EUROGIN program.

 
HPV genotyping – a tool for triage and patient management

As each high-risk HPV (hrHPV) genotype carries a different risk of progression to cervical cancer, HPV genotyping can be used to manage HPV-positive women accordingly.  The use of HPV genotyping for triage and management is gaining importance worldwide. HPV16/18 positivity is currently being included in several clinical algorithms to support the direct referral to colposcopy. The inclusion of extended genotyping and further identification of the other hrHPV genotypes, is being piloted to further stratify patient risk and guide their management.  

Questions arise on whether HPV screening tests need to be redesigned to include other or less HPV genotypes.  Making these decisions will be quite challenging and will take several years, and input from epidemiology studies will be needed.