“We have the medical tools to eradicate cervical cancer”
This year’s Rudbeck Prize winner, Ulf Gyllensten, has devoted much of his career to improving cervical cancer diagnosis. Photo: Tobias Sterner/Bildbyrån
Ulf Gyllensten and his colleagues became pioneers when they developed a home testing kit for the HPV virus. The test proved to be as safe as the tests taken in health centres and also increased the number of women participating in cervical cancer screening. Now he is being awarded this year’s Rudbeck Prize for his efforts.
Women in Uppsala were the first in Sweden to be offered home testing kits for the HPV virus. Instead of going to a gynaecologist or midwife for a pap smear screening, they were able to test themselves at home and then send in the sample for analysis. Gyllensten and his colleagues were responsible for this convenient solution.
“In 2006, we started offering home testing to anyone who had not come to the screening. At that time, as many as 40 percent chose to take the test directly. After several subsequent studies, we found that women found the test easy to take, that it could be taken on any day of the menstrual cycle, and that it was as reliable as if performed by a medical professional. In addition, we were able to show that switching to self-sampling would save a lot of healthcare resources,” explains Gyllensten, Professor of Medical Molecular Genetics at the Department of Immunology, Genetics and Pathology.
The Olof Rudbeck Prize
Every year, on Olof Rudbeck Day, the Olof Rudbeck Prize is awarded for outstanding achievements in basic research that have been of significant clinical significance.
Gyllensten shows the handy slips of paper they produced for analysing HPV. The woman samples herself and then places a small amount of vaginal secretion on the slip of paper that is sent to the laboratory for analysis. Photo: Tobias Sterner/Bildbyrån
A cancer that can be eradicated
Cervical cancer is one of the few cancers for which the cause is actually known. When an HPV infection does not heal on its own, it risks leading to cell division that the body no longer controls. However, this is a relatively slow process, which is why screening is so important.
“The problem is that about 20 percent of women do not attend the screening. They don’t take the time, find it unpleasant or there are cultural or religious reasons for not wanting to be examined. And these are the women who have the highest risk of developing cervical cancer.”
Self-sampling that does not require a visit to a gynaecologist has been shown to result in more women choosing to participate. Another important tool for reducing the incidence of cervical cancer is getting a high proportion of people vaccinated against HPV. Although HPV vaccination is now offered to both girls and boys, not everyone takes it up. According to Gyllensten, the vaccination rate must reach 90 percent to have the desired effect. If society succeeds in that, the rewards could be considerable.
“We currently have the medical tools to eradicate a cancer. That is groundbreaking! There are still some barriers to overcome, but in a country like Sweden it should be possible. In other parts of the world where cervical cancer is much more common, such as Africa, there are high hopes that the use of effective vaccines and self-sampling screening will reduce this cancer and save the lives of hundreds of thousands of women.”
Important to discover ovarian cancer in time
The lab is now focusing on developing diagnostic methods for endometrial cancer (cancer of the uterus) and ovarian cancer as well. In the case of ovarian cancer, it is particularly important to detect the patients in time.
“The five-year survival rate is less than 50 percent; it is one of the worst cancers anyone can get.”
Because the disease is so dangerous, many women who are suspected of having ovarian cancer undergo surgery as a precaution – often after the doctor has found unclear changes in the ovaries using ultrasound. The risk is that those with harmless changes will be operated on unnecessarily.
“We have been working on developing new diagnostics – biomarkers in the form of proteins that can be analysed in a blood sample – which can tell us whether the change seen on the ultrasound is benign or a sign of cancer. And the situation is actually looking pretty positive – the precursors of cancer are visible in the blood proteins.”
The long-term goal is to develop a test that can detect all forms of gynaecological cancer in good time. It is hoped that this can be combined with the screening currently carried out for cervical cancer.
“Building up a screening programme is a very large undertaking. However, if we can offer screening that can detect multiple forms of gynaecological cancer, it will be both cheaper for the healthcare system and more motivating for more women to participate.”
Gyllensten completed his postdoc in the 1980s at the company that developed the PCR method used to analyse DNA. It was thanks to this method that he then managed to find HPV in vaginal secretions. Photo: Tobias Sterner/Bildbyrån
This year's Rudbeck Prize winner
In connection with Rudbeck Day 2024 on 18 October, Gyllensten will give a lecture on his research. He will also receive the Rudbeck Prize at the event – an award given annually for “achievements in basic research of major clinical importance.”
“I am very flattered and happy to receive the prize, as it is one of the finest honours we have in our field. It is a recognition of the work that I and my colleagues have done over many years, and it is also an incentive to continue the project to find biomarkers for the other cancers. The aim is to detect the precursors of the most common gynaecological cancers at an early stage, thereby reducing the risk of developing any of these types of cancer.”
Sandra Gunnarsson