5.1. Guideline dissemination and impact

This recommendation will be integrated into a full consolidated version of WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition, along with the outputs of the next phases of the guideline update, in the near future.

In brief, the outputs of each phase and the final consolidated second edition will be disseminated using WHO’s worldwide network to make sure that the guideline reaches health-care providers and programme managers so that the most recent evidence is integrated and accessible for clinical decision-making to prevent cervical cancer. The full dissemination strategy was approved for the second edition and includes dissemination on the WHO website and in the next edition of HRP News, and printed copies will be disseminated upon request to health ministries, WHO country and regional offices, WHO collaborating centres on cervical cancer, and other cervical cancer collaborators and partners. Policy briefs and an app will also be produced. The guideline will be translated into the six WHO official languages.

Dissemination plans also include partners involved in the implementation and roll-out of cervical cancer screening and treatment programmes. These include other United Nations agencies, the United States President’s Emergency Fund for AIDS Relief (PEPFAR), the Global Fund and Unitaid.

WHO headquarters will work with WHO regional offices and country offices to ensure that countries will be supported in the adoption, implementation and monitoring of the guideline. For this purpose, regional workshops and webinars in different languages will be organized to present, discuss and plan guideline adaptation and implementation, as well as to update current national guidelines.

In addition, impact of the fully updated and consolidated second edition will be measured by developing and disseminating surveys for both health workers and clients, as was done during the guideline development on the topic of values and preferences. This will be done a year after release to assess any changes in country policies and national guidelines. This will also assess the reach of the guideline and ultimately its impact in changing practice.

Over the next year, WHO’s Comprehensive cervical cancer control: a guide to essential practice, which was last published in 2014 (15), will be revised to provide an up-to-date and global consolidation of all recommendations to prevent cervical cancer.

5.2. Guideline update

Evidence for the sensitivity and specificity of the different tests addressed in the full updated guideline (including in this present guidance, focusing on HPV mRNA testing) and evidence on the impact of these tests on important outcomes is accumulating, and syntheses of this evidence are needed. These syntheses will be used in a continual process to develop new recommendations – as part of the “living guidelines” approach – in the final phase of the guideline update (33).

The GDG will continue to work with the WHO Secretariat in an ad hoc manner, so that the research gaps identified during the process can be addressed. The GDG anticipates that as data and experience with new screening tests and modalities advance, new recommendations will be needed through a living guideline process that is able to rapidly respond and evolve.