IRBLleida helps shape future global cervical cancer prevention strategies

An international study published in EClinicalMedicine, involving the Institute for Biomedical Research of Lleida (IRBLleida) and the World Health Organization (WHO), concludes that colposcopy is an acceptable option for the triage of women who test positive for human papillomavirus (HPV). This finding, which integrates data from more than 13,000 women across several continents, may help inform future global clinical guidelines for the early detection of cervical cancer.

The study, which involved Joan Valls, professor at the University of Lleida and researcher in the Health Care Research Group (GReCS), was conducted in collaboration with researchers from the World Health Organization (WHO), the U.S. National Cancer Institute (NCI), and institutions in Belgium, Norway, India, and China. The research assessed the effectiveness of colposcopy as a triage test for women testing positive for HPV, the main cause of cervical cancer.

The study reviewed and pooled data from 11 international studies involving a total of 13,111 women. Of these, 5,849 belonged to cohorts contributed by researchers affiliated with IRBLleida from several Latin American countries, making the Lleida-based institute the largest data contributor to the entire research project.

"Our findings show that colposcopy is a valid alternative for identifying which HPV-positive women require more immediate assessment and treatment. According to the analysis, this strategy demonstrates high sensitivity for detecting cervical precancerous lesions and could be particularly useful in settings where ensuring patient follow-up after a positive screening result is challenging," explained researcher Joan Valls.

These findings are especially relevant in the context of the WHO strategy to eliminate cervical cancer as a public health problem. One of the key challenges in achieving this goal is identifying the most efficient triage methods following HPV detection, enabling the early identification of women at risk of developing precancerous lesions or cervical cancer.

"This work builds on a line of research that began three years ago when we first published data on the diagnostic performance of colposcopy as a direct triage method for HPV-positive women, using a cohort of more than 40,000 women from nine Latin American countries. That study was published in The Lancet Global Health. The new research expands the analysis to additional world regions, including Asia, Africa, and Australia, allowing for an even more comprehensive evaluation of colposcopy," added Valls.

The research was funded by the World Health Organization (WHO); the European Commission's Horizon 2020 Research and Innovation Programme; the European Joint Action EUCanScreen; and the European Commission Initiative on Cervical Cancer.

Article: Dhollander N, Jaafar I, Almonte M et al. Accuracy of colposcopy to triage HPV-positive women in cervical cancer screening: a systematic review and meta-analysis. eClinicalMedicine, 2026; 96.

Related research

• Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus: results from the ESTAMPA multicentric screening study.
• Valls J, Baena A, Venegas G et al. Performance of standardised colposcopy to detect cervical precancer and cancer for triage of women testing positive for human papillomavirus: results from the ESTAMPA multicentric screening study. Lancet Glob Health. 2023 Mar;11(3):e350-e360. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(22)00545-9/fulltext