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Women’s Healthcare
“Have women’s voices at last been heard in government health strategy?” Dr Lisa Cameron MP, Chair of the All-Party Parliamentary Health Group
“This mainstream menopause focus is going some way to break the taboo and normalise conversations, but action also starts at home.”
Jasmin Adebisi, Policy Project Coordinator for Health, Policy Connect
Dr Anne Connoll MBE, Chair, Primary Care Women’s Health Forum (PCWHF)
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IN THIS ISSUE
“Breast awareness is not about looking for cancer, it’s about getting to know what is normal for you.”
Have women’s voices at last been heard in government health strategy?
Clare O’Neill Health Information Manager, CoppaFeel!
Research indicates that women may live longer than men but are more likely to spend more of their life in ill-health compared to men.
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he Government’s recently published Women’s Health Strategy aims to tackle this gender health gap. It was informed by a call for evidence to allow women, their families and healthcare experts to share their experiences, priorities and concerns — and nearly 100,000 people responded.
“Women are now waiting longer than ever for care.” Dr Edward Morris, President, Royal College of Obstetricians and Gynaecologists (RCOG)
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COMING SOON It is Iron Deficiency Day on 26th November a global occasion where we unite to raise awareness of iron deficiency. Keep an eye out for our upcoming ‘Senior Health’ issue where we will explore the symptoms in more detail.
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Training implementation efforts A common theme was that healthcare professionals require better training regarding women’s health. The strategy addresses this and outlines that, from 2024, all medical students and incoming doctors will be trained on how to assess women’s health, examined through medical licensing examinations. This is a good long-term solution. However, for existing staff in the short term, the strategy only offers optional extra courses to improve their knowledge. With the NHS facing workforce pressures, it seems unlikely that many existing professionals would be able to take such a course forward in the near future. Health inclusivity in question Another welcomed development has been the appointment of England’s first Women’s Health Ambassador, Professor Dame Lesley Regan. Professor Regan advocated for the expansion of women’s health hubs across the UK to help women access treatment and support for a range of issues. These hubs provide an opportunity to make routine inquiries surrounding domestic abuse and contribute to efforts to tackle violence against women and girls. We are pleased that the strategy announces an expansion of hubs which make services much more accessible. However, in some areas, the strategy does not go far enough to improve outcomes for women and girls. A recent UK report showed that Black women are four times more likely and Asian women three times more likely to die in pregnancy than white women. While the new maternities taskforce — established earlier this year — is a good step, the new strategy does not outline its role in tackling disparities and addressing racial injustice.
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A recent UK report showed that Black women are four times more likely and Asian women three times more likely to die in pregnancy than white women. Consideration for all health aspects Women’s mental health was not comprehensively addressed in the strategy, despite 39% of people responding to the call for evidence saying it is a priority. Further detail is also required on how the strategy will be implemented, considering the current workforce crisis and funding. The All-Party Parliamentary Health Group and Policy Connect are looking forward to continuing our vital work in this area to address women’s health.
To learn more, visit policyconnect.org.uk/aphg
WRITTEN BY Dr Lisa Cameron MP Chair of the All-Party Parliamentary Health Group
WRITTEN BY Jasmin Adebisi Policy Project Coordinator for Health, Policy Connect
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Why we need crucial conversations in breast cancer Crucial conversations on a range of subjects between patients and healthcare professionals (HCPs) are critical in breast cancer care.
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INTERVIEW WITH Marie-Andrée Gamache Country President, Novartis UK & Ireland
hese might include an honest conversation with a secondary breast cancer patient about issues with intimacy or menopause, a discussion about biomarker testing or between healthcare professionals about a particular patient’s care” says Marie-Andrée Gamache, who is Country President for pharmaceutical company, Novartis, in the UK and Ireland. Better outcomes Gamache acknowledges that these ‘crucial conversations’ also extend to the life sciences industry and the healthcare system on ways to work together for better patient outcomes in the breast cancer space, particularly for secondary breast cancer that has spread elsewhere in a patient’s body. As the industry tackles the ‘second healthcare crisis’ of treatment backlogs from the Covid-19 pandemic, she outlines Novartis’ has a long-standing commitment to breast cancer care, underpinned by collaboration and science. “I believe the life science industry can play an important role in helping the NHS build back better after the pandemic, including in oncology.” Industry partnerships can improve patient’s quality of life Cross-industry partnerships with “bold solutions, close collaboration and ground-breaking innovations,” are vital to improving the quality of life for breast cancer patients, says Gamache. They have partnered with The Christie NHS Foundation to
understand and address inequalities of access to secondary breast cancer services across Greater Manchester, with the project analysing findings from 3,032 patients to inform service developments. “We’ve taken a bold approach with our research and patient trials, working with healthcare systems to identify new pathways or mutations that may play a role in disease progression and developing therapies that increase overall survival outcomes for patients, while not only maintaining but also improving the quality of life for patients” Gamache adds. Supporting patients Since 2021, Novartis has supported Breast Cancer Now to deliver the Living with Secondary Breast Cancer Face-to-Face groups service. “This service offers monthly therapist facilitated, peer-to-peer support groups” says Gamache. “The groups enable women to meet those going through a similar experience. They share their crucial conversations by talking, listening and learning with people who understand the challenges that secondary breast cancer brings.” Furthermore, Novartis is supporting conversations between patients and their healthcare professional through its ‘Moments That Count’ campaign, which provides resources and support about secondary breast cancer for all patients and their families to live the fullest life possible.
She advises other secondary breast cancer patients to “advocate for themselves” and speak to medical support teams.
One woman inspires many secondary breast cancer patients Within the space of 40 hours, Lisa Fleming received the devastating double diagnosis that changed her life.
A INTERVIEW WITH Lisa Fleming Founder of Make 2nds Count
PAGE WRITTEN BY Mark Nicholls
UK | September 2022 | 237255
fter Lisa was told she had breast cancer, a further scan revealed it had spread throughout her bones. “I did not have any typical symptoms. To be told I have metastatic secondary breast cancer and that it was incurable—my world fell apart,” recalls Lisa, 39, from Edinburgh. Treating secondary breast cancer At that point in 2017, Lisa was told her care would be palliative; but after two high-risk operations in her neck and spine, she began aggressive chemotherapy. Fourteen further surgeries and other continued treatment followed, but as Lisa remarks: “The girl that was given the initial prognosis that I would probably not see Christmas is
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now here — five years on.” During this journey, Lisa met many other women in the same position. She hopes to inspire other secondary breast cancer patients to realise that it is possible to live a full life after such a diagnosis. Crucial conversations Lisa also points to the importance of ‘crucial conversations’ about care and prognosis with healthcare professionals. While her oncologist has been open in ‘two-way conversations’ with her, she says with some patients, there is a massive gap in care information. This may be about maintaining better quality of life or topics like menopause and fertility. She thinks people should be provided with more literature to take home.
Education void Acknowledging that it can be difficult when overwhelmed by such a diagnosis, she was motivated to set up ‘Make 2nds Count’ for secondary breast cancer patients. Now a nationwide charity, it has three pillars of research, support and education. As part of this work, Lisa supports the Novartis ‘Moments That Count’ campaign, a platform of resources and advice to “fill that education void about metastatic breast cancer.” Lisa, now founder of Make 2nds Count and an ambassador for Moments That Count, ran a themed events business for children before she was diagnosed. She underlines the importance of making patients aware of the signs and symptoms of secondary breast cancer — noting she had little knowledge of the disease before diagnosis. Achieving quality of life For Lisa, one of the biggest turning points has been in learning how to live again and live well with metastatic breast cancer and finding joy in things she sees as the ‘old Lisa.’ This includes singing and performing on stage—things Lisa didn’t think she would do again.
Find out more at momentsthat count.co.uk This page was commissioned and funded by Novartis Pharmaceuticals UK Ltd.
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How family history knowledge of cancer could save your life
Hormonal breast changes such as sensitivity, leaking nipples and increased size are all natural in pregnancy.
A simple lifesaving tool can help discover if you are at higher risk of developing ovarian cancer — and therefore eligible for a genetic test on the NHS.
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f your family has a history of cancer, you should check to see if you could be at risk. That’s the message from Marie-Claire Platt, Head of Policy and Research at Ovarian Cancer Action. Identifying the gene mutation “Your family tree is extremely important when it comes to assessing your risk of developing certain hereditary cancers,” says Platt. “For example, 20% of ovarian cancers are caused by gene mutations passed down from either your mother or father; and 15%–18% of these are caused by mutations in the BRCA1 and BRCA2 genes.” One in 200 of the UK population carries a BRCA gene mutation — that’s an estimated 535,000+ people with increased cancer risk. However, only about 5% of carriers have been identified so far. “To save lives, we need to find many more,” says Platt, “because there is no screening tool for ovarian cancer and survival rates are low.”
The health importance of breast awareness during pregnancy In our years of talking to young people about their breasts and chests, we noticed that pregnancy and breastfeeding were seen by many as a barrier to breast awareness.
One in 200 of the UK population carries a BRCA gene mutation. How an online tool can save lives If someone knows they are a carrier of the BRCA gene mutation, they could reduce their risk of developing ovarian cancer with preventive surgery. The only way to know if you are a carrier is through a genetic test — although, to have a test on the NHS, you must fulfil certain eligibility criteria. However, in 2018, Ovarian Cancer Action launched a Hereditary Cancer Risk Tool to assess your eligibility for NHS testing. “It involves completing a simple questionnaire,” says Platt. “If it finds you are eligible, your GP can refer you to a genetic screening clinic.” Information for prevention So far, over 50,000 people have used the tool, but Platt urges all women with cancer in their families to follow suit. “Because no one else is going to make connections between you and your family members who may have had ovarian cancer,” she says. “We want people to have as much information as possible to stop themselves from getting this disease.” INTERVIEW WITH Marie-Claire Platt Head of Policy and Research, Ovarian Cancer Action WRITTEN BY Tony Greenway
Paid for by Ovarian Cancer Action Find out more at ovarian.org.uk/risktool
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e know how important it is for everyone to get to know their bodies and talk to their doctor if they notice any unusual changes.
Identifying changes Pregnancy — like puberty, menstruation and menopause — is a natural condition but often comes with breast changes. The difficulty of knowing the difference between these natural changes compared to signs and symptoms of breast cancer is perhaps the reason why pregnant women with breast cancer are doubly likely to be diagnosed at stage four.1 At CoppaFeel!, we are committed to addressing this health inequity by improving the confidence of breast awareness during pregnancy and breastfeeding. ‘Pregnancy boobs’ Hormonal breast changes such as sensitivity, leaking nipples and increased size are all natural in pregnancy. Despite the initial adjustment to these fluctuations, checking is the best way to get used to them and identify any potential problems. Breast conditions such as mastitis or blocked ducts should be properly diagnosed by a doctor and, if in doubt, it is important that breast cancer is ruled out. An ultrasound scan is a safe and effective way to do this. We want to move away from dismissing breast conditions related to pregnancy as ‘just pregnancy boobs,’ and improve education about breast health for pregnant and breastfeeding people. Awareness guidance Our breast awareness message during pregnancy and breastfeeding remains the same, and our breast awareness tips are as follows:
Breast conditions such as mastitis or blocked ducts should be properly diagnosed by a doctor and, if in doubt, it is important that breast cancer is ruled out. Look and feel: Some symptoms of breast cancer are visible, not just palpable. All breast tissue: Breast tissue goes up to the collarbone and under the armpits. Roughly once a month Get to know your normal: Breast awareness is not about looking for cancer, it’s about getting to know what is normal for you. References 1. Public Health England National Cancer Registration and Analysis Service, 2018.
CoppaFeel! is creating an information booklet about breast awareness during pregnancy and breastfeeding, launching in 2022. For more information about this and all our other resources, go to coppafeel.org
WRITTEN BY Clare O’Neill Health Information Manager, CoppaFeel!
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The impact of bladder leakage on physical and mental health is widely ignored It’s important for women to realise that while bladder leakage isn’t uncommon, they shouldn’t have to put up with it.
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he NHS estimates between three and six million women suffer from bladder leakage in the UK. But the actual number is likely to be much higher, as Dr Dawn Harper points out, “Those are just the cases we know about.”
WRITTEN BY Aggy York GP and former sufferer of bladder leaks
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Bladder leakage as a taboo Research conducted at Contrelle Activgard found that 66% of women affected are too embarrassed to kickstart a conversation, and only 28% would mention their suffering to their partner. Contributing to the issue is the media’s reluctance to speak about leakage, perhaps viewing it as an old person’s issue. This couldn’t be more wrong. Affecting women from their 30s Sufferers are active women who are experiencing a condition which is detrimental to them living their lives to the fullest. The research highlights that leakage is most likely triggered by everyday activities such as sneezing, coughing, laughing and exercise. This results in many women constantly being concerned about leaking. As Natalie Silverman, 44, a former sufferer explains, “It just made me feel quite sad. I wanted to play with my son, chase him, jump on the trampoline, and I always had to say I couldn’t.” This is something I identify with as a former sufferer. I remember just breaking down and crying. It was souldestroying because I knew I was doing everything I should be doing, yet it wasn’t having any impact. Although he would always advocate for sufferers to
follow the NHS recommendations, Ash Monga, Consultant Gynaecologist at University Hospital Southampton, explains “Unfortunately, losing weight, reducing caffeine and pelvic floor exercises aren’t the answer for everyone, and many women don’t want to consider surgery.”
Unfortunately, losing weight, reducing caffeine and pelvic floor exercises aren’t the answer for everyone, and many women don’t want to consider surgery. A new solution One new option in the UK market, which I have found success with, is Contrelle Activgard. It is a U-shaped piece of soft, body-compatible foam, which is easily inserted into the vagina using a reusable applicator. Once in place, it works by gently supporting the neck of your bladder and urethra so that the bladder is in the correct position to stop leaks immediately. Women can use the device independently, and it can be bought directly. Trials demonstrate that in two out of three cases, women are completely dry when the device is in place. For me, personally, Contrelle has been a revelation. I’m not only keen to pass on news about the solution I’ve found but also to get everyone to speak openly about the issue.
Promoting breast health awareness and getting to know your normal
for breast cancer as a result of the disruption. Despite the valiant efforts of NHS staff, we estimate that as of July 2022, almost 8,000 people are living with undiagnosed breast cancer in England.
O WRITTEN BY Manveet Basra Head of Public Health and Wellbeing, Breast Cancer Now
Get to know your normal It’s so important to be breast aware and get to know ‘your normal’ and understand what’s new or different for you. While most breast changes — including breast lumps — are not cancer, it’s important to get any new or unusual change checked by your GP. On the occasions it is breast
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To get your half-price Sizing Kit, simply enter Freedom1 at the checkout on contrelle.com
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It’s so important to be breast aware and get to know ‘your normal’ and understand what’s new or different for you.
This Breast Cancer Awareness Month, around 5,000 people will be diagnosed with breast cancer. Whatever your age, it’s important to be breast aware.
ctober marks Breast Cancer Awareness Month — 31 days dedicated to spotlighting breast cancer. With one woman diagnosed with breast cancer every 10 minutes, it’s a vital opportunity to spread breast awareness messages to all sectors of society.
For more information about Contrelle Activgard, please visit contrelle.com or boots.com
cancer, the sooner it is diagnosed, the better the chances of treatment being successful. Checking your breasts only takes a few minutes. It could be while getting dressed, showering or putting on moisturiser. Check your whole breast area, armpits and up to your collarbone (upper chest) for changes. There’s no special technique — it’s as simple as TLC: Touch, Look, Check. No time to waste At Breast Cancer Now, we’re acutely aware of the pandemic continuing to present unparalleled challenges for people affected by breast cancer. In 2020/21, almost a million fewer women in England were screened
Breast screening is vital in detecting breast cancer early — when treatment is more likely to be successful. This is why we encourage women to attend breast screening appointments when invited and why we’ve relentlessly shone a spotlight on this backlog. As part of our #notimetowaste campaign, we’re calling for the Government to urgently set out how it will address the screening shortfall and find these missing women and for a more ambitious target for patients receiving a breast cancer diagnosis or having it ruled out within 28 days of urgent referral. Anyone seeking information or support about breast health can speak to our expert nurses via our free, confidential helpline on 0808 800 6000 or via our online ‘Ask Our Nurse’ service. Visit: breastcancernow.org/information-support/support-you
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Action must be taken to remove barriers for women accessing gynaecological care
Empowering women to break the menopause taboo
Gynaecology waiting lists continue to grow, and waiting times are having a severe impact on women who are left to suffer from worsening symptoms.
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he pandemic has put extra strain on the NHS, and women are now waiting longer than ever for care. Across the UK, waiting lists for gynaecology reached nearly 610,000 women as of March 2022. This is just over a 69% increase since pre-pandemic levels. Gynaecology waiting lists in England had a disproportionately high growth compared to all other elective specialities. Gynaecological conditions and the impact on quality of life Awareness of gynaecological conditions and health is growing, and many will now be familiar with common conditions such as endometriosis, fibroids, polycystic ovary syndrome (PCOS) and incontinence. What is less recognised is the impact that common gynaecological conditions can have on women’s quality of life. Common symptoms of gynaecological and urogynaecological conditions include heavy menstrual bleeding, chronic pelvic pain and incontinence. The prolonged waits that women are facing often mean that women are left with debilitating and worsening symptoms for far longer than they should. In England, the number of women and people waiting over a year for care is at its highest point ever in gynaecology, increasing from 66 in February 2020 to just over 34,000 at the end of June 2022. In a survey of over 800 women waiting for gynaecological care, more
than 75% of respondents reported that their symptoms had worsened while they waited for treatment. On top of this, 80% of respondents reported that their mental health had worsened. The overall impact is that these prolonged waits severely affect women’s quality of life, their mental health and their ability to work and socialise. Moving away from ‘benign’ The RCOG is calling for the impact of gynaecological conditions to be fully recognised and for a shift in the way that gynaecology is prioritised across the health service. The impact on physical and mental health, quality of life, ability to work and socialise and the possible impact on fertility must be considered for women waiting for care. With the recent publication of the Women’s Health Strategy, gynaecology waiting lists can no longer be ignored. There must be a move away from using the term ‘benign’ to describe gynaecological conditions. Gynaecology has been seen for too long as a second-class speciality. We are working with policymakers and the NHS to ensure the effective recovery of gynaecology services and that meaningful action is taken to meet the needs of women on waiting lists. WRITTEN BY Dr Edward Morris President, Royal College of Obstetricians and Gynaecologists (RCOG)
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More than 50% of the world’s population will go through menopause. Yet there is a lack of understanding around identifying symptoms and talking about their impact. The stigma remains.
WRITTEN BY Dr Anne Connolly MBE Chair, Primary Care Women’s Health Forum (PCWHF)
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rom couched conversations around ‘The Change’ to embarrassment discussing symptoms and the struggles to manage, people experiencing menopause or perimenopause have often hidden away. But change is coming. Health for women The Government’s recent Women’s Health Strategy for England saw over a third of respondents request menopause to be included.1 Responses highlighted that menopause is a taboo subject that cannot be talked about openly, and this impacts symptom management — often meaning that people do not get the support they want and need. Media coverage of menopause has also picked up momentum, with Davina McCall’s exploration of the effect of menopausal symptoms and the BBC Breakfast ‘Wake up to the Menopause week,’ where our own campaign — Rock My Menopause — launched. This mainstream menopause focus is going some way to break the taboo and normalise conversations, but action also starts at home. Menopause champions At Rock My Menopause, we proudly encourage our community to be a #Menovist. We stand up for those experiencing menopause, openly encourage and engage in menopause conversations and play a part in stamping out the taboo. This is intended to normalise conversations and spread the message that menopause is something that happens and can be talked about openly.
This mainstream menopause focus is going some way to break the taboo and normalise conversations, but action also starts at home. Start today It’s easy to become a Menovist. It starts with a single conversation. Take the step today, ask a question, share your experience and open up a discussion. Play your part, however big or small, in breaking the taboo. If you’re not scared to say the ‘M’ word and want to bring menopause and perimenopause into the wider society, then you’re a #Menovist. Wear your badge with pride. Building a community of informed and empowered people — whether that’s friends, family or employers — to champion menopause and support those experiencing it is the best way to break the taboo. It allows people to feel more comfortable speaking up and can also help others understand their symptoms and get the support they need. References 1. Women’s Health Strategy for England https://www.gov.uk/government/publications/ womens-health-strategy-for-england/womens-health-strategy-for-england#menopause
Rock My Menopause is a campaign of the Primary Care Women’s Health Forum (PCWHF), a group of 10,000 healthcare professionals with a special interest in women’s health. Find out more at rockmymenopause.com @RockMyMenopause | #RockMyMenopause | #Menovist
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Non-invasive treatments help patients solve incontinence issues Contrary to the notion of surgery as the only option for treating urinary incontinence, newer non-invasive treatments, such as Erbium YAG (Er:YAG) laser and high-intensity magnetic technology are gaining recognition.
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rinary incontinence is one of the most common health problems that negatively impact the female quality of life. Physiotherapy, kegel exercises and lifestyle changes (caffeine reduction, physical activity, etc.) are typically the first treatments offered to women suffering from involuntary urine leakage. When this fails, surgical therapy is traditionally recommended.
WRITTEN BY Dr. Neza Koron Medical Research Specialist, Fotona
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Considering non-invasive options Surgical procedures come with risks of complications such as long-term pain, temporary difficulty urinating, painful sex and more. To avoid these risks, more women are opting for safer and incision-less options, such as vaginal laser treatment and pelvic floor muscle strengthening with HITS™ (High Intensity Tesla Stimulation) magnetic technology.
Non-invasive laser therapy has recently entered the official guidelines for treating stress urinary incontinence — issued by the associations of gynaecologists and obstetricians in Germany, Austria and Switzerland. The safety and effectiveness of non-ablative Er:YAG laser gynaecology treatments have also been confirmed by more than 70 SCI published studies with over 113,000 patients treated in the past eight years.
The safety and effectiveness of non-ablative Er:YAG laser gynaecology treatments have also been confirmed by more than 70 SCI published studies with over 113,000 patients treated in the past eight years.
How laser therapy works IncontiLase® is a non-invasive erbium laser therapy for treating mild and moderate stress urinary incontinence. It uses patented Fotona SMOOTH® technology to deliver laser light to the vaginal surface through a special handpiece, similar to a speculum used during a Pap test. The result is precisely controlled heating of the tissue, triggering the formation of new collagen and tissue renewal. The strengthened vaginal wall offers improved support to the bladder and urethra, improving the symptoms of incontinence. Usually, three sessions are recommended.
Laser + magnet = the perfect combination Fotona SMOOTH® laser treatment and IntimaWave® therapy are each effective treatments on their own. However, more effective results can be achieved by combining both the laser and magnetic treatments. This dual-treatment approach helps to regenerate tissue and restore pelvic floor strength with low risk and optimal efficiency, providing a truly patient-friendly alternative for treating incontinence.
UK employers failing to support women’s reproductive healthcare needs
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Read more at fotona-smooth.com
granted appropriate medical leave under the same conditions set out in general employer/employee medical policies. No legal right for time off work Shockingly, there is also no legal right in the UK for time off work for fertility treatment. Fertility Network, together with MP Nickie Aiken, is campaigning for this appalling situation to end. In June 2022, Ms Aiken put forward a Private Members’ Bill which, if passed by Parliament, will give fertility patients the right to paid leave for medical appointments.
Outdated and inadequate workplace policies are failing women needing fertility treatment.
Glaring gap in reproductive health workplace policies The UK pioneered fertility treatment but workplace policies are yet to catch up. Infertility is defined as a disease by the World Health Organization with its treatment requiring women to undergo complex, time-sensitive and sometimes lengthy medical intervention. Yet, within the workplace, the majority of UK employers don’t grant time off for fertility treatment, as they do for medical or surgical appointments. Instead, women have to use annual leave, take unpaid leave, cut back working hours and sometimes leave employment, in order to travel to and attend the necessary multiple fertility clinic appointments. A 2016 survey by
High-intensity magnetic technology Another non-invasive option involves sitting on a comfortable IntimaWave® chair with built-in magnetic applicators. The patient can remain fully clothed while the magnetic applicators in the chair stimulate muscle contraction in the entire pelvic floor area, leading to increased muscle strength and effective relief of uncontrolled urine flow. Multiple sessions over a few weeks are needed for optimal results. These can help treat female and male urinary incontinence safely and painlessly.
Fertility Network found that half of women needed more than a week off work for a treatment cycle, while the average number of days taken off was 8.7. Recognise infertility as a legitimate health condition This glaring gap in workplace support fails many women and their partners. In 2019, according to the Human Fertilisation and Embryology Authority, 53,000 women, most in employment, underwent fertility treatments such as IVF. That’s why Fertility Network UK, the national fertility charity, is calling for employers to recognise infertility as a legitimate health condition. Doing so would allow fertility patients to be
WRITTEN BY Gwenda Burns Chief Executive, Fertility Network UK
Shockingly, there is also no legal right in the UK for time off work for fertility treatment. Fertility is support good for business and employees Fertility Network believes supporting anyone facing fertility challenges is good for business as well as employees. Forward-thinking businesses are recognising this, with more firms joining our Fertility in the Workplace initiative, which helps companies implement a fertility policy and ensures staff and managers understand the impact of fertility and treatment so they can support those around them. MEDIAPLANET
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A breakthrough in HPV screening: a hope to defeat cervical cancer Cervical cancer ranks as the second most common cause of cancer deaths in women aged 15 to 44 and the ninth most frequent cancer among women in Europe.
D INTERVIEW WITH Monika Destruelle Sr. EMEA Product Manager, HPV, BD WRITTEN BY Sheree Hanna
espite the vigorous NHS cervical cancer screening programme in the UK and high-profile campaigns to encourage younger women to attend for testing (such as one prompted by the death of TV personality Jade Goody), there is still a high percentage of women not showing up. Cervical screening is available for people with a cervix aged 25 to 64 in England. In the past few years, statistics have shown that there is a small year-on-year decline in the number of women attending. In 2020–21, 4.59 million individuals were invited for screening (a 1% decrease from the previous year). Of those, 70.2% of eligible individuals were adequately screened. Reasons for skipping Monika Destruelle, European Product Manager HPV for global medical technology company BD, says there is a myriad of reasons for the 30% or so women who do not go for screening. “It might be that they feel too embarrassed, hold certain religious beliefs, find it uncomfortable, or they will skip their appointment that day because they simply didn’t have time,” she says. “Over half of all cervical cancers are diagnosed in women who have never been screened or have not been screened in the previous five years — a situation that has been compounded by the global pandemic. There were large disruptions in services and programmes.”
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Elimination goal Now, things are set to improve with the arrival of an at-home, self-collection method of testing. Additionally, in 2020, the World Health Organisation (WHO) launched its global strategy to Accelerate the Elimination of Cervical Cancer. “WHO says that 90% of women should be screened by 2030 — that is their target,” says Destruelle. “At-home, selfcollection has the most potential to help address the urgent public health challenge of reaching women who do not regularly attend or have access to cervical cancer screening.” The BD Onclarity™ HPV assay, with extended genotyping, received the industry’s first at-home, self-collection claim
for HPV screening (CE-marked). It is approved for use with samples collected using appropriate devices outside of healthcare facilities. What makes this technological breakthrough special is that it has been able to combine laboratory testing techniques with simultaneous genotyping. The assay detects and identifies 14 high-risk human papillomavirus (HPV) types in a single analysis and provides genotyping information from specimens collected for cervical cancer screening processes. Home collection kits Destruelle explains: “If a woman is exposed to any of those 14 genotypes for a longer time, the cells may change and transform into cancer cells with very different risks between them.” “We believe that self-collection can really help to increase participation. Every woman that is screened is a gain because for every type of cancer we can avoid, there is a life behind it.
In the past few years, statistics have shown that there is a small year-on-year decline in the number of women attending. “In the future, it will eventually become the routine method for screening because of other factors like the rapidly decreasing workforce and the increasing need to make cost savings.” The home collection kit will comprise of a swab and instructions on how to do the quick test. It is then returned to the relevant testing labs via posting. BD is currently going through validation processes with the NHS and screening laboratories to make the kits available here within the next three to five years. Destruelle says: “In Europe, the CE marking alone is not enough. We believe that, combined with the current screening programmes and the HPV vaccine, we will eventually reach our goal of eradicating this type of cancer.”
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