6 – Deliver and disseminate the research outcomes of the Compass trial, C4 and other policy relevant research

SIX

DELIVER AND DISSEMINATE THE RESEARCH OUTCOMES OF THE COMPASS TRIAL, C4 AND OTHER POLICY RELEVANT RESEARCH

COMPASS TRIAL AND THE SUPPORTING COMPASS REGISTER

The Compass Trial is a key piece of Australian research supporting the National Cervical Screening Program. Compass is the largest clinical trial in Australia, conducted by VCS Foundation and Cancer Council NSW. The roll out of the Compass pilot has already delivered major benefits to the Department and the NCSP by informing the implementation of the renewed screening pathway in December 2017, including laboratory and registry processes. It is expected to inform future changes to the NCSP by confirming that the HPV test is a superior screening method and to assess different ways of deciding which women need further investigations. This is particularly important to understand in the context of Australia’s HPV Vaccination Program, where vaccinated and unvaccinated cohorts are participating in cervical screening. The trial will answer a lot of different questions for the program around demand, the pathway and safety. Compass recruitment closed in January 2020. VCS Foundation has continued to operate the Compass Register to support healthcare providers and the 76,000 trial participants until the conclusion of the Compass Trial. The Compass Register routinely accepts and records cervical screening test information along with information about related investigations, such as colposcopy, biopsy and treatment in order to provide follow-up services in accordance with the Compass Trial protocols. As women complete their participation in the Trial, the Compass Register manages the exit of participants with their complete records transferred to the National Cancer Screening Register. VCS Foundation is working closely with the Australian Department of Health and Telstra Health to establish and implement processes to facilitate the safe exit of participants from Compass to the National Cancer Screening Register. The work is overseen by a Governance Committee and supported by key project leads from each organisation committed to ensuring the best possible outcomes for transferring participants. VCS Population Health is leading this work for VCS Foundation.

The services of the Compass Register include the following: + The Compass Hotline for participants and healthcare providers + Reminders and communication to women participating in the

Compass Trial + Management and provision of screening histories to healthcare providers and laboratories + Monitoring and follow up of trial participants + Provision of reports to healthcare providers to remind them when participants are due for their next

Compass screening test, and + Data processing and reporting.

THE COMPASS TRIAL OUTCOMES WILL PROVIDE CRUCIAL EVIDENCE TO GUIDE HEALTH STRATEGIES BOTH IN AUSTRALIA AND OVERSEAS

RELEASE OF THE C4 2021 CERVICAL CANCER ELIMINATION REPORT: AUSTRALIA’S PROGRESS TOWARDS THE ELIMINATION OF CERVICAL CANCER AS A PUBLIC HEALTH PROBLEM

The NHMRC Centre of Research Excellence in Cervical Cancer Control (C4) brings together Australia’s leaders in cervical cancer control, in both HPV vaccination and cervical screening, with researchers from VCS Foundation, Cancer Council NSW, Kirby Institute at UNSW Sydney, and the University of Melbourne. The work of C4 investigators has underpinned Australia’s major innovations in public health in terms of the successful delivery of HPV vaccination in girls and boys and the implementation of an HPV-based cervical screening program. Led by Prof Julia Brotherton, this inaugural report will be the first in a regular series on Australia’s progress towards the elimination of cervical cancer as a public health problem. The report is based on 11 key indicators grouped into 4 components framed by the World Health Organisation (WHO) ‘90/70/90’ 2030 scale-up targets for elimination, derived from the most recently available data. The two goals of the report are to monitor progress towards achievement of targets and to provide recommendations for improving the quality, availability and timeliness of indicator data. The following table shows the four reporting components, framed by the WHO ‘90/70/90’ 2030 scale-up targets for elimination, contained in the report: Disease outcomes Reducing cancer incidence and mortality are the goals of cervical cancer control programs. High-grade cervical disease is the precursor to cancer, preventable by vaccination and prevented and detected through screening and precancer treatment. HPV infection is preventable by vaccination and changes in prevalence are detectable earlier than falls in high-grade cervical disease or cancer. Vaccine coverage Indicators in this component monitor the ongoing implementation and reach of the vaccine program. Coverage by age 15 years is the standard measure recommended by WHO to allow comparisons over time and between populations, given that the routine age at vaccination is variable but recommended between the ages of 9 and 14 years.

Screening participation

Indicators in this component monitor the implementation and reach of the cervical screening program, considering Australia’s recent transition from a two-year screening interval under the previous cytology-based program to a five-year interval in the HPV-based program. Treatment uptake Indicators in this component monitor the rate at which women reach further assessment following a positive screening test and rates of treatment for high-grade cervical disease and cancer.

https://www.cervicalcancercontrol.org.au/publications/reports/

This is a multi-institutional agreement in partnership with:

2021 CERVICAL CANCER ELIMINATION PROGRESS REPORT:

Australia’s progress towards the elimination of cervical cancer as a public health problem

CONQUERING CANCER CAMPAIGN

VCS Foundation and the C4 CRE are proud sponsors of the Conquering Cancer Campaign, a social impact communications initiative that celebrates the efforts made to eliminate cervical cancer around the world.

The Conquering Cancer Campaign will amplify the achievements of countries where elimination is imminent and encourage decision-makers in other nations to advocate for change and urgent action. Over 18 months from September 2020 to April 2022, Moonshine Agency will create, release, promote and publicise a series of original films, photographs, stories and visual communications in 10 languages. These include VCS Foundation’s contribution to the Eliminating Cervical Cancer in Australia and Removing Obstacles to Cervical Screening (Program ROSE) short videos. This wave of awareness will strengthen the existing movement to eliminate cervical cancer. The campaign is backed by strategically aligned organisations and their members who will engage decision-makers worldwide, with the objective of promoting action by introducing vaccination, screening and treatment programs. To view the campaign, go to https://www.facebook.com/ ConqueringCancerCampaign/

POLICY-RELEVANT RESEARCH AND EVALUATION ACTIVITIES SPECIFIC TO THE VICTORIAN CONTEXT

The VCS Population Health research team continues to undertake research and evaluation projects of Victorian public health activities supporting cervical cancer prevention and eventual elimination. Professor Julia Brotherton has assumed a part time position as Professor of Cancer Prevention Policy and Implementation in the Evaluation and Implementation Unit of the Centre for Health Policy at the Melbourne School of Population and Global Health, University of Melbourne. Collaborative projects involving the University of Melbourne, and other key partners include: + Victorian Department of Health funded qualitative evaluation of self-collection cervical screening implementation experiences in

Victoria from participant and provider perspectives. This was published in the Medical Journal of Australia and received significant media coverage. + Victorian Department of Health funded multimethod evaluation of the North West Melbourne COVID-19

Response Cancer Screening Project, which aims to improve participation in self-collection based cervical screening, bowel screening and hepatitis screening. + Victorian Cancer Agency funded

Project Grant Improving the benefits of the renewal of the National

Cervical Screening Program for

Victorian Aboriginal women. This implementation research study is codesigning strategies to support cervical screening and follow up with

VACCHO and ACCHOs across Victoria.

A co-designed strategy of offering universal access to self-collection is currently underway at BADAC as part of this Project. + Victorian Cancer Agency Cancer

Prevention and Screening Research

Grant. Piloting a model of universal self-collection for cervical screening in primary care in Victoria: The solution to a decade of declining participation and to longstanding inequity? This study will support practices to implement a choice of self-collection to all people eligible for cervical screening and evaluate effectiveness of support tools and universal access on uptake of cervical screening in Victoria.