FIGO Cancer Report 2021.

Abstract

The FIGO (International Federation of Gynecology and Obstetrics) Committee for Gynecological Oncology is pleased to present the FIGO Cancer Report 2021. This Report contains updates on the management of gynecological cancers combined with pertinent papers on gynecological oncology, which we hope the reader will find stimulating and educational. The Report is also the conduit where changes to the FIGO staging of cancers are reported and in this issue we present the revised FIGO staging for carcinoma of the vulva.1 Revision of staging is inevitably an enormous task and takes time to become embedded into clinical practice as clinicians adapt to the new staging, along with the changes necessary in IT systems used for data collection and in cancer registries. Careful consideration is required prior to changing any cancer staging and the Committee was unanimous that these modifications were justifiable. The changes are based on an improved evidence-based staging process, simplified and aligned with the clinical care of patients while retaining the prognostic implications of staging. Staging will never encompass every possible clinicopathological situation that can arise, but we are confident that the new modification addresses the majority. As before, other selected topics appear in the Report—surgical training, obesity in cancer, concepts on how to address the ever-expanding role of molecular staging, to name but some—and hopefully these topics will be of interest to all. A special chapter has been devoted to the impact of the COVID-19 pandemic on cancer care. It would be remiss not to acknowledge how the pandemic has impacted the way the Committee works, with face-to-face meetings rendered impossible. The Committee now meets through video conferencing every four months. While this has its own challenges, in real terms it is most likely the way meetings will continue to be held in the foreseeable future. Using this method, the Committee has been able to achieve its goals despite the difficulties posed by the pandemic. The Committee has progressed FIGO’s involvement in the international endeavor to eliminate cervical cancer. Many international organizations, including the World Health Organization (WHO), International Gynecologic Cancer Society (IGCS), National Institutes of Health (NIH), and others, are focused on this goal. Within FIGO, two specific areas were identified where this objective could be supported. Firstly, funding was identified to support competitive grants for pilot projects on cervical cancer elimination focused in low- and middle-income countries (LMICs). Hopefully, this will assist in the development of larger projects in the future. Applications and the awarding of grants should be completed in 2021. Secondly, is the ongoing development of educational modules to assist doctors and other health providers in the palliative care of women with cervical cancer. In many LMICs there is a lack or paucity of this service and the objective is to educate and give practical advice to those caring for women presenting with terminal stage cervical cancer or women progressing to a terminal phase while in their care. Working with eCancer—an organization with years of experience in developing modules in cancer care—the African Palliative Care Association, and AORTIC, the first series of these education modules is planned for the near future. Subsequently, and working with the relevant organizations, further modules for other world regions are planned. The Committee also participated in the FIGO webinar series, presenting a range of topics in a webinar on ovarian cancer, which was well received. There are plans to undertake more webinars in the future that will cover recent developments in other gynecological cancers. Looking forward, maintaining FIGO’s ongoing association with the Union for International Cancer Control (UICC), the American Joint Committee on Cancer (AJCC), the International Agency for Research on Cancer (IARC), WHO, and other international organizations remains an important aspect of the Committee's work. The Cervical Cancer Elimination Project will continue for some time and continue to develop. Regarding staging of cancers, the Committee continues to monitor new developments and assess the relevance and need to make amendments to staging classifications. The members of the Committee for Gynecological Oncology during this term were: Sean Kehoe, Chair (UK), Neerja Bhatla, Immediate Past Chair (India), Alexander B. Olawaiye (USA), Mauricio A. Cuello (Chile), Aikou Okamoto (Japan), Sarikapan Wilailak (Thailand), Gerard Lindeque (South Africa), Jonathan S. Berek (USA), Chittaranjan N. Purandare (India, ex-officio), and Joanna Cain (USA, co-opted). Going forward, another notable change within FIGO is that committee terms will now be for two rather than three years. Whilst this may sound challenging, improved streamlining of the processes around committee members should enable committees to commence work immediately where previously there were delays of some months in finalizing membership. This is a new era for FIGO and part of the ongoing changes to modernize the Federation over the coming years. The authors have no conflicts of interest.