The World Health Organization recommends switching to HPV testing to eliminate cervical cancer

Cervical cancer remains an important public health problem in India, with approximately 127,000 new cases and 80,000 cervical cancer-related deaths reported annually.

According to the statement, regular screening of women over the age of 30 at intervals of 3-5 years can detect precancerous and potentially cancerous cervical lesions, but coverage has remained poor despite the inclusion of visual inspection with acetic acid (VIA) in the national screening program for the three common cancers, namely breast cancer, oral cancer, and cervical cancer.

Persistent infection with carcinogenic types of human papillomavirus (cHPV) is the necessary cause of cervical cancer. The World Health Organization has recommended moving to HPV testing as the best strategy to achieve cervical cancer elimination, the statement said.

With approved HPV tests, just two rounds of screening at ages 35 and 45 will be enough to achieve elimination of cervical cancer. However, most HPV tests are expensive, require sophisticated technology, and are not accessible in last-mile facilities.

A point-of-care (PoC) testing approach for HPV detection could represent a major breakthrough in affordable diagnostics for early detection and management of cervical cancer, allowing positive cases to be treated on the same day, according to the statement.

Proof-of-concept (PoC) tests have potential to expand as a low-cost screening tool in India and low- and middle-income countries (LMICs), according to a new multicenter study published in the International Journal of Cancer.

The study was conducted at leading institutions, including AIIMS New Delhi; ICMR-National Institute of Cancer Prevention and Research, Noida (NICPR); and the National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, in collaboration with the World Health Organization’s International Agency for Research on Cancer (IARC), France, and supported by DBT-BIRAC Grand Challenges India.

The aim was to evaluate original HPV DNA testing platforms for use in primary cervical cancer screening. While several Indian tests have been developed, they have not been validated against international standards set by the World Health Organization. Four point-of-care tests were evaluated, and two were found to be suitable for use in the national program.

The study is among the first to apply the WHO target product profile (TPP) and IARC criteria to evaluate low-valent HPV assays for tests developed in India, said Dr. Neerja Bhatla, professor emeritus, NCI and former head of the Department of Obstetrics and Gynecology at AIIMS New Delhi, and lead author and coordinator of the study.

The first step was to propose the development of HPV tests with the eight most common HPV types in cervical cancer, which could be performed in facilities at district and sub-district levels and required minimal training and experience. These innovations aim to overcome the limitations of current tests, which were largely developed in high-income settings and target a wide range of HPV types, increasing cost and complexity.

“This study demonstrates that homegrown platforms can achieve clinical validation, quality standards and accuracy that are comparable to global standard tests. It will be a game-changer for cervical cancer prevention and early detection in India,” said Dr Bhatla.

Dr Shalini Singh, Director, ICMR-NICPR, emphasized that HPV DNA testing for women at the age of 35 years and again at the age of 45 years is key to WHO’s strategy to eliminate cervical cancer. However, high costs hinder widespread implementation in low- and middle-income countries. “Affordable local solutions are essential to expand screening coverage and reduce the burden of disease,” she stressed.

Dr Shaukat Hussain, one of the co-authors, highlighted that the validated platform has strong potential for national-level integration into screening programmes, as district-level staff are already familiar with its use. He added that future developments, such as self-sampling and high-throughput adaptations, could further enhance accessibility.

The results are expected to support India’s goals of eliminating cervical cancer while providing a scalable model for other low-resource settings globally. While HPV vaccination, recently introduced as a national campaign, will make a notable difference for the younger generation, there is an urgent need to incorporate HPV testing for more effective screening of women over 30 years of age who are at risk of cervical cancer. Years