IARC 60th Anniversary - 19-21 May 2026
Session : Rapid Fire
Health service readiness to integrate HPV-based screening and vaccination among vulnerable populations within the HPV-FASTER-Implement project
BAUSSANO I. 1, ELFSTRÖM M. 10, DILLNER J. 10, PARTHA B. 1, MOSQUERA I. 1, TISLER A. 1, RAMIREZ A. 1, TRANBERG M. 2, AXELSEN A. 2, KIRKEGAARD P. 2, ANDERSEN B. 2, BARDOU M. 3, HASSINE A. 3, FRANC C. 4, MENVIELLE G. 5, ROTAR I. 6, MURESAN D. 6, BABAN A. 7, TAUT D. 7, ALBU A. 7, ROBLES C. 8, PEREMIQUEL-TRILLAS P. 8, ARES-VILAR A. 8, BOSCH X. 9, GINI A. 1
1 IARC staff, Lyon, France; 2 Department of Public Health Programmes, Randers, Denmark; 3 Université Bourgogne Europe, Dijon, France; 4 4CESP, Inserm UMR 1018, Villejuif, France; 5 University Paris Saclay, Villejuif, France; 6 51st Departement of Obstetrics and Gynecology, Cluj Napoca, Romania; 7 Universitatea Babes Bolyai, Cluj Napoca, Romania; 8 Catalan Institute of Oncology (ICO) - Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain; 9 Catalan Institute of Oncology (ICO) - Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Spain; HPV World, Barcelona, Spain; 10 Center for Cervical Cancer Elimination, Karolinska Institutet, Stockholm, Sweden
Background
Cervical cancer (CC) is preventable, yet approximately 26,000 women die annually in Europe. Low human papillomavirus (HPV) vaccination uptake and insufficient screening coverage contribute to higher incidence, particularly among vulnerable populations. Based on the evidence of protection extended to women beyond traditional adolescent vaccination age groups, the HPV-FASTER approach (concomitant HPV-based screening and HPV vaccination) has been proposed as a strategy to accelerate CC elimination in Europe.
The HPV-FASTER-Implement project aims to evaluate in five intervention countries strategies that integrate the HPV-FASTER approach for vulnerable groups aged 25–45 years, including migrants and sex workers in Spain and Sweden, women living with HIV and transgender men in Denmark, incarcerated women in Romania, and women living in deprived areas in France.
Objectives
The overall objective of the assessment was to evaluate the readiness of health systems in the five intervention countries to introduce the HPV-FASTER approach among vulnerable adult populations.
Methods
We adapted the Cervical cancer screening related Service Availability and Readiness Assessment (CervScreen-SARA) protocol and tools, considering also the WHO Effective Vaccine Management tool. The protocol is a three-step process covering: 1) a desk review of guidelines and policies in place; 2) facility visits of screening, colposcopy and vaccination services; and 3) interviews with macro and meso level stakeholders. Potential interviewees include policymakers, members of CC screening and vaccination programmes, and health professionals working with vulnerable populations.
Triangulation of the information allowed the identification of strengths and areas of improvement in implementing the HPV-FASTER approach.
Results
Overall, 94 references were reviewed, and services were visited at 24 locations, including specialised facilities (e.g. those attended by sex workers, individuals living with HIV or transgender men) where individuals will be offered the HPV-FASTER approach. Interviews were conducted with 14 stakeholders.
Across intervention countries identified barriers included fragmented services, limited access, especially where walk-in options are absent, and shortages of educational, multilingual, and culturally adapted materials. Weak outreach capacity, low awareness of CC prevention, language and cultural barriers, and vaccine hesitancy among populations and some health professionals were also reported.
Key opportunities for the HPV-FASTER-Implement project include prior experience with screening and vaccination programmes, openness of health professionals to innovation, strong willingness to participate, strengthening collaboration with NGOs and mediators, and patients’ trust in their health professionals.
Conclusion
This protocol offers a structured approach to assess the readiness of health systems to deliver combined HPV vaccination and HPV-based CC screening to vulnerable populations. Findings will allow the tailoring of the strategies to strengthen CC prevention services.