ESGO cooperation with WHO

Dear colleagues and friends,
In no uncertain warlike terms, ESGO has declared war on cervical cancer many years ago.

However, the ESGO is not a society of declarations, but actions. To continue with the war metaphor, we have developed weapons and launched attacks over the last months.

The more effective weapon is quality of care.
ESGO is developing under the leadership of David Cibula a set of documents, all available on the eAcademy portal, with the aim to guide the physicians in their day-to-day fight.

Specifically, the ESGO guidelines for the management of cervical cancer were developed in 2018 in collaboration with ESTRO and ESP, jointly published in three Journals (International Journal of Gynaecological Cancers, Radiotherapy and Oncology, European Journal of Pathology), printed in booklets, translated in several major European languages, and made available on the increasingly used ESGO Guidelines smartphone App.

As per our exclusive guidelines elaboration process, the cervical cancer guidelines were developed by a multidisciplinary geographically balanced group of experts, and submitted for review to ESGO members from many countries, in order to make sure that optimal guidelines are applicable in all parts of Europe.

ESGO, ESTRO and ESP jointly agreed on regular updates of these guidelines, and the launch of the first update is planned to be one of the attractions of the ESGO 2020 State of the Art Conference in Copenhagen, Denmark.

In 2019, quality indicators for surgical cancer development will be elaborated using the same high-quality process and will become one of the highlight sessions in ESGO 2019.

A new educational activity in the pipeline is Advanced Course on Management of Locally Advanced Cervical Cancer : From guidelines to practical management in cooperation with ESTRO.
The course will feature an overview of evidence-based theory combined with live transmission of surgery and demonstration of brachytherapy manual skills, and will be held for the first time in January 2020.

Incidentally, ESGO has decided not to take sides in the controversy on the use of minimally invasive surgery deriving from the LACC study. Instead, ESGO prefers to support a Pan-European retrospective study led by Luis Chiva and to discuss with other concerned societies, like ESGE and SERGS, on how the results of this study, and the consequents of the controversy, can be reasonably incorporated in clinical practice.

Prevention creates much less collateral damages and avoids losses.
For this reason, ESGO has reactivated its Prevention Task Force (another military metaphor) under the productive leadership of Murat Gultekin, a significant stakeholder in the field of organised screening, renowned for his achievements in the organisation of HPV screening in Turkey. In cooperation with the European Federation of Colposcopy, a joint position paper on vaccination has been elaborated and will soon be published.

On top of that, an official statement on vaccination, in collaboration with the EFC and the EBCOG, is in preparation. It will be published in medical and lay media.

The next steps planned for 2019 include:
+ an additional ESGO-EFC Joint Statement on Cervical Cancer Screening,
+ a meta-analysis by Marc Arbyn on triage of HPV positive cases funded by the ESGO,
+ another systematic review on How To Asses Cone Materials conducted by Maria Kyrgiou and funded once again by ESGO together with relevant societies such as EFC and ESP.

ESGO believes strongly in taking an advocacy role and raising awareness in the prevention of gynaecological cancers.
ESGO not only produces the science but also makes an impact on a growing global population and policymakers through ENGAGe, an elaborated network of cancer survivors and advocates.
For example, ESGO-ENGAGe released in a simple lay language a set of cancer factsheets, as well as HPV vaccines and cervical cancer screenings leaflets, which were also translated into ten languages.

All of ENGAGe products are available for free download at the ENGAGe website and the local advocacy websites. ESGO members and hospitals can print and use these releases for their patients.

ENYGO, our incredible group of young gynaecological oncologists, is enthusiastically taking its share with peaceful actions. For example, the famous bike ride, Ride4Women,  led by Rene Laky, a repetitive awareness event, with the complete support of ESGO, and will cross the Balkans, drawing the attention of the public on the acute need to act against cervical cancer and its precursors.

ESGO is not the only organisation to fight against cervical cancer.
We need to collaborate to win the war. 
The most powerful and influential institution, the World Health Organization, is conducting a global action, with an ambitious goal of eliminating cervical cancer through the HPV vaccination for every young girl on the planet, and through the screening and treatment of pre-cancerous lesions in women over 30.

Very relevantly, WHO also wants to take action in improving access to diagnosis and treatment of invasive disease, a great initiative which will offer millions of patients worldwide the opportunity of prevention.

ESGO is actively contributing to this substantial and unprecedented effort. Murat Gultekin attended a meeting of the WHO consultation on the Increase Access to Screening and Treatment, leading to ESGO's involvement in developing WHO's roadmap of activities.

ESGO will be continuously involved in the technical support of WHO and countries for implementing screening programs, particularly in the WHO-defined European area.

Denis Querleu attended the recent consultation to develop a technical package on the management of cervical cancer, where he facilitated the discussion on monitoring of early diagnosis and treatment and quality of care indicators, a topic in which ESGO has extensive experience.

Last, the revised FIGO staging for cervical carcinoma was officially published in January 2019, and is now much better adapted to clinical management. The FIGO committee kindly accepted the input of gynaecological cancer societies, including ESGO.

This incredible list of positive actions certainly places ESGO in the front line in the battle against cervical cancer. However, an army takes its value from the action of its soldiers – its members.

This letter is not only a presentation of our coordinated strategic action against the women killer named cervical cancer. It is also a call for everyone to aim relentlessly at improving the quality of care for each patient, to put in practice cost-effective screening, and to tirelessly fight against the fake news regarding vaccination against HPV circulated in newspapers and social media.

Sincerely,
Denis Querleu
ESGO President