Putting women at the heart of the 10 Year Cancer Plan
Hologic UK and Ireland’s General Manager, Tim Simpson, outlines three steps to ensure cancer screening delivers positive outcomes for women over the next decade.
The COVID-19 pandemic caused significant disruption for cancer screening programmes across the UK, with a wave of missed or late appointments.
But the pandemic has also provided us with an opportunity to re-evaluate how we deliver crucial public health interventions, including breast and cervical cancer screening. The Government’s decision to develop a new 10 Year Cancer Plan is therefore a very welcome initiative.
In particular, Hologic, as a women’s health company, believes that there is an opportunity for a renewed approach to breast and cervical cancer screening in the UK, which would place the needs of women at the heart of the service.
We think there are three crucial steps that need to be taken to realise this vision.
1. Giving women the knowledge to make decisions over their screening
Firstly, we need to provide women with an understanding of their own personal risk of cancer, to allow them to make lifestyle and other choices that reduce that risk, and underscore the importance of screening.
The Government should provide each woman with a comprehensive cancer risk assessment at the start of their screening journey, to allow future screening to be personalised accordingly.
Take breast density, for example. Breast Cancer Now estimates that over 700,000 people in the UK of breast screening age are at higher than average risk of developing breast cancer due to having a high breast density. And yet, research undertaken by Hologic last year revealed that that only 20% of women were aware that having dense breast tissue is a cancer risk.
The full adoption of a quantifiable breast density assessment software would allow women with dense breasts to be accurately identified and prioritised potentially for more frequent screening. The screening interval for lower risk women could be extended, creating a more efficient and targeted breast screening programme.
2. Faster, more accurate and less fearful screening processes for women
The second step is ensuring that women can be confident that the screening process will be as anxiety free as possible, by giving access to the most effective screening technology available.
Investing in technology such as 3D MammographyTM for breast cancer screening would help provide the reassurance that women deserve. 3D Mammography detects up to 65% more invasive breast cancers, and safely reduces recalls of patients by up to 40%, when compared to traditional 2D Mammography alone.
Likewise, wider adoption of HPV mRNA tests for primary cervical cancer screening would provide women with greater reassurance, because HPV mRNA tests are more specific than their traditional DNA counterparts. They therefore only identify active cases of HPV infection, and so fewer women would need to be recalled for further checks such as colposcopies.
For example, for a baseline population of 2.25m women, the adoption of mRNA HPV tests would result in 28,009 fewer unnecessary colposcopies being undertaken.
3. Building capacity and efficiency in screening using Artificial Intelligence (AI) technology
The final step centres on better realising the incremental benefits of AI, and using this cutting edge technology to improve efficiency and capacity within screening programmes.
For many women, the time in between attending a screening appointment, and receiving results, can be one filled with anxiety. AI technology provides an opportunity to reduce this anxiety by ensuring that capacity does not negatively impact on the speed with which results are returned.
In breast cancer screening, on average, radiologists take 13% less time to read a breast cancer screening image when assisted with AI, freeing up time to review more mammograms or concentrate on those at highest risk.
In cervical cancer screening, the AI driven imagery of Digital Cytology evaluates tens of thousands of cells from a single patient in around 30 seconds, and presents the most relevant diagnostic material to a cytologist. The cloud-based nature of this technology means that cyto-screeners across an entire network can review cervical screening images remotely, allowing spare capacity to be used wherever available in the country.
An opportunity to redefine our approach to cancer screening
The new 10 Year Cancer Plan offers an opportunity to reimagine how we deliver breast and cervical cancer screening, placing women’s needs at the centre of the process.
Women should be confident that they understand their personal cancer risk, will be given access to the very best screening technology, and that capacity within the system will not impact their experience.
These three steps will create screening programmes fit for the decade ahead.
 Data cited relates to a survey of 2,000 UK women aged 45-74 conducted by Opinium on behalf of Hologic from 17 December 2020 to 4 January 2021. Survey report Agile Number MISC-07550-EUR-EN, Name: Breast Cancer Awareness Phase II Survey Report (UK, Spain, Germany)
 Friedewald SM, Rafferty EA, Rose SL, Durand MA, Plecha DM, Greenberg JS, et al. Breast cancer screening using tomosynthesis in combination with digital mammography. JAMA, 2014 Jun 25;311(24):2499-507.
 Weston G, Dombrowski C, Harvey MJ, Iftner T, Kyrgiou M, Founta C, et al. Use of the Aptima mRNA high-risk human papillomavirus (HR-HPV) assay compared to a DNA HR-HPV assay in the English cervical screening programme: a decision tree model based economic evaluation. BMJ Open 2020 Mar 8;10(3):e031303. doi:10.1136/ bmjopen-2019-031303. PMID: 32152154; PMCID: PMC7064071.
 Keller B, Kshirsagar A, Smith A. 3DQuorum™ Imaging Technology. Improving radiologist performance through Artificial Intelligence and SmartSlices. WP-00152-EUR-EN Rev 001 (10/19) US/International © 2019 Hologic, Inc.
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