Objectives; How to eliminate cervico-vaginal cancer in Japan. Session time; 60 mins. Cervical cancer incidence has been rising since the late 1990s to 11 per 100,000 women, and this rise is particularly prominent in women of reproductive age in Japan. While the recent resumption of the active recommendations of HPV vaccine was a critical step forward, there are still unresolved issues and fundamental challenges in monitoring and achieving the global targets. Dr. Rei Haruyama aims to synthesize these issues and provide considerations for enhancement of cervical cancer control in Japan. Dr. Tomomi Nakahara investigated mechanisms for HPV genome replication and maintenance in HPV life cycle. She identified that HPV genome can be maintained in an E1, a viral DNA helicase, independent manner in basal cells of the stratified epithelium by using a tissue culture model to recapitulate HPV life cycle. She will discuss how these findings could be exploited to develop a new therapy to eliminate the viral persistence and prevent cervical cancer. Dr. Kaori Okayama developed a system to identify 39 HPV types including all high-risk (HR), all possibly high-risk (pHR), and some low-risk (LR) HPV types using molecular mapping or a single cell sorting procedure. HPV genotyping using cervical or vaginal cell samples reveals that HR-HPV types are predominantly in the uterine cervix, LR-types in the vagina, and pHR types equally in both sites. Tissue tropisms in different HPV-risk types may help us to understand HPV carcinogenesis in the cervico-vagina, providing useful information in clinico-pathological diagnosis.

Despite being almost entirely preventable, over half a million people develop cervical cancer annually. In 2018, the WHO deemed elimination of cervical cancer a global public health priority, and in 2020, adopted the Global Strategy for Cervical Cancer Elimination, setting three specific targets: 90% of girls fully vaccinated by age 15; 70% of women screened by age 35, and again by 45; and 90% with abnormal results or cancer treated/managed. This symposium will focus on the second target: achieving 70% screening coverage; more specifically, the role of HPV-based self-collection in increasing coverage among different populations. Many jurisdictions have implemented or are planning for HPV-based screening, and several have implemented a self-collection component within their programs. Panelists from regions with experience in HPV-based self-collection will share implementation experiences, reflections, and future directions for self-collected cervix screening. Globally, this is a pivotal time: expanding self-collection beyond the under-screened offers the potential to also enhance screening opportunities for those already engaged in cervix screening programs. The impact of the COVID-19 pandemic, and other global changes have catalyzed opportunities for innovation and expansion of traditional provider-centered, screening approaches. Symposium attendees will hear directly from experts regarding real world experiences, lessons learned, and how HPV-based self-collection for cervix screening can be implemented more broadly and effectively in a variety of settings. Learning Objectives: Describe self-collection implementation experiences and lessons learned Describe the potential for expansion of HPV-based self-collection approaches beyond the under-screened This symposium will be endorsed by the Canadian Partnership Against Cancer Duration: 90min