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Knowing that cervical cancer is the third most common cancer in women worldwide and following WHO recommendations that each country should have a human papillomavirus reference laboratory, Belgium has set up the National Reference Centre for Human Papillomavirus (NRC HPV) in 2016.
The NRC HPV consists of a consortium between Sciensano (Brussels), AML (Antwerp) and the University Hospital of Ghent (UZ Gent). Sciensano acts as coordinator of the NRC; the molecular diagnosis for virus detection and HPV typing is performed at AML; the next-generation whole genome sequencing is done by UZ Gent.
Cervical cancers are associated with persistent cervico-vaginal human papillomavirus infections. Sexual contact is considered to be the prominent route of HPV transmission. More than 200 HPV types have been isolated and characterised but not all of these types play a role in cervical cancer.
The objectives of the NRC HPV are the organisation of a structured surveillance system for HPV, including a follow-up of HPV genotypes in vaccinated versus non-vaccinated cohorts (women < 30 years old), virus testing on histologically confirmed cervical cancer cases, on specific HPV-related cancer cases (head-and-neck tumours, anal dysplasia and cancer) and on 10% of the CIN3 cases. When HPV negative cancers are found (after negative confirmation exploiting three different HPV assays), samples are subjected to next-generation whole genome sequencing.
With the introduction of the HPV test, self-sampling became a valid option to reach out towards formerly non-attenders. The optimal method for processing material from self-samplers has currently not yet been identified. Therefore, this consortium will develop standard operating procedures for processing of material from self-sampling devices (Evalyn and Qvintip) on different (commercial) test systems. The concordance of different HPV assays in self-samplers will be measured.
Since 2016, 1200 samples per year are analysed for the follow-up of HPV genotypes in vaccinated versus non-vaccinated women < 30 years old. Statistical analysis is ongoing.
In 2018-2019, a HPV ring test will be initiated and evaluated for Belgian clinical laboratories.