Professor Karen Canfell AC’s research has impacted cancer control policy across multiple cancers. Her team’s modelling and clinical trial findings on cervical screening in a Human Papilloma Virus (HPV) vaccinated population were central to the 2017 transition of Australia's National Cervical Screening Program to primary HPV screening. Her work has supported the Australian and World Health Organization (WHO) strategies to accelerate the elimination of cervical cancer, and her team continues to support WHO global guidelines for cervical screening. Professor Canfell is the recipient of the NHMRC Elizabeth Blackburn Investigator Grant Award for Leadership in Health Services Research for her research into the effective implementation and scale up of the WHO strategy to eliminate cervical cancer in Australia, the Indo-Pacific and globally.
I originally trained in engineering and was always interested in the role of technology in improving health. In the early 2000s, I went to Oxford University to do a Doctor of Philosophy in cervical cancer epidemiology. I was very lucky to meet Dame Valerie Beral (28 July 1946 – 26 August 2022), the then Head of the Cancer Epidemiology Unit, and someone who became my supervisor and thereafter an incredibly important mentor until she passed away a few years ago.
I worked on the Million Women Study, learning about the importance of large scale data analysis and also had the opportunity to develop an initial model of cervical screening working with the National Health Service in the United Kingdom on addressing topical questions on screening policy.
Our team’s first NHMRC Project Grant began in 2006 and under this grant, we performed data driven modelling of the impact of HPV vaccination on disease outcomes and cervical screening. At the time there was excitement about the very high prophylactic vaccine efficacy seen in the pivotal vaccine trials, but very little discussion about what future impact HPV vaccines could have on cervical screening.
This really interested me and over the next period (and to this day) as our work focused on questions of how to improve cervical screening using new technologies and approaches, and how to optimise screening in a vaccinated population.
Through work on our major Australian trial compass, I became very interested in the possibilities of achieving cervical cancer rates so low that elimination might be possible.
Our team did the first country specific and global elimination modelling which led to work with WHO. There were several exciting years from 2018 to 2020 when we were actively supporting the WHO elimination planning process.
Since then, my interests have moved into successful implementation of elimination, which requires understanding of many different challenges faced by countries. I am now involved in leading the Elimination Partnership in Cervical Cancer (EPICC) which is supported by the Australian Government and the Minderoo Foundation and is providing technical support to many countries in the Indo-Pacific.
In low and middle income countries, cervical cancer is one of the highest burden cancers in women and the disease burden is much higher than Australia.
Over the next few years, I hope to see the promise of EPICC fulfilled, and through my Investigator Grant, harness this incredible opportunity to build on the current evidence base. This will allow us to improve elimination efforts and also to extend them to strengthen approaches to control of other cancers in low -and middle income countries.
Our broader team’s work is across cancer control, and other methods and findings have been relevant to major policy and practice decisions in colorectal cancer screening, in lung screening, and in PSA testing, among other areas. We have called our team the Cancer Elimination Collaboration, not because elimination is necessarily feasible right now for other cancers, but because the framework has been so successful in prompting evidence based action across the cancer control spectrum.
The concept of elimination has also helped to harness and coordinate action from many stakeholders globally and that is what is needed to change outcomes in cancer control at a global level.
It is important that we continue to contribute to the evidence base in Australia, particularly around equity and addressing the needs of underserved communities and under resourced areas of cancer control. In other countries, particularly low-and-middle-income countries, large scale initiatives like EPICC are designed to address global inequities and expected to save lives.
It is always important to ground ourselves in the people and the communities we are working for, and we try to do that in many ways, through multiple connection points with individuals and communities.
I am very honoured to receive this NHMRC Elizabeth Blackburn Investigator Grant Award for Leadership in Health Services Research. NHMRC funding has been central to our team’s work over the years, and it has provided the foundation for our broader program to provide policy, practice and implementation support to governments.
I specifically want to acknowledge how much health services and population health research depends on the efforts of multidisciplinary teams. All our achievements are those of our whole research team (now at the University of Sydney). Our team includes many amazing researchers, and our identity as a team is more than the technical work we do. Our team also includes many early career researchers, and it is so exciting to contribute to the development of talented people in our space. I am also so grateful for the close collaborations with our many colleagues in Australia and internationally, and with the leaders in the countries in which we work.