Cervical cancer screening feasibility study MorocOncoE6 comparing VIA with molecular HPV oncogene expression testing
20 September 2018 (online)
Visual inspection with acetic acid (VIA) is the standard cervical cancer screening in Morocco. OncoE6 Cervical Test (Arbor Vita, CA, USA) is an oncoprotein-based lateral flow assay designed for dysplasia detection. MorocOncoE6 is a pilot study to compare screening methods and their acceptability.
200 women were recruited in health posts and a swab sample, a cytobrush and a home-taken self-sample (Evalyn brush, Rovers Medical Devices, The Netherlands) was obtained. Questionnaires were used to inquire acceptability. All women got colposcopy and biopsy for histology in a reference center. HPV genotyping was performed.
A screening cohort of 200 women living in rural (100) or urban (100) area in Tangier was recruited from 25.12.17 till 07.03.18. Participation rate was 89%. All participants provided self-collected and two clinician-collected specimens and underwent VIA. OncoE6 Cervical Test was done for the self-collected and physician-collected swab. 31 women had positive VIA and 6 women a positive OncoE6 Cervical Test. Women judged self-sampling as easy and preferable. HPV genotyping data and histology (7 low grade dysplasia, 27 HPV infection signs, 2 squamous cells metaplasia were found) data and questionnaires (knowledge of cervical cancer, socio-demographic characteristics, medical history and acceptability of the Evalyn® brush self-collection) will be correlated to screening test results.
This feasibility trial establishes technical and logistical prerequisites, and preferably acceptable and efficient screening tools in the Moroccan cervical cancer screening program. Self-sampling is well accepted. The 6 fold higher referral rate after VIA is problematic for the overburdened healthcare system.