Implementing high-risk Human Papillomavirus Self-Sampling for Cervical Cancer Screening in Ghana: A Pilot feasibility study (CARCISCAN)

The recommendations of the World Health Organization (WHO) include recommendations for high-risk Human Papillomavirus (hrHPV) based cervical cancer screening, as to reach the 90-70-90 goal for cervical cancer elimination by 2030. The countries with the highest incidence of cervical cancer are mainly low- and middle-income-countries (LMIC) and often do not have any standardized screening approach. The objective of our study is to evaluate the feasibility of a cervical cancer screening program with hrHPV self-sampling women in a low resources setting.

Our study is set in Techiman (Ghana) where there is a high incidence of cervical cancer and no screening. Our approach included that 30–49-year-old, non-pregnant women were invited to participate in a hrHPV testing with self-sampling kits. The primary hrHPV negative cohort will be encouraged to re-screen after 3-5 years and will be excluded from the study analysis. Women who test positive for hrHPV are invited to undergo visual assessment of the cervix at colposcopy with 5% acetic acid. If there is suspicion of invasion, cervical biopsy is performed, while any areas that meet the criteria for treatment (major lesions) will be thermally ablated using Liger thermocoagulator. Follow-up after treatment will be undertaken after 6 weeks with VIA and after 6 months with hrHPV self-sampling. We are aiming to assess a standard that is feasible and potentially adoptable by other LMICs around the world.

Data collection is ongoing and first data analysis is expected for Autumn 2024. At the current moment (June 2024) about 500 women have already been screened.

Study Design: Pilot study, prospective cohort study design

Primary Outcome: Feasibility

Secondary Outcomes: Cost-effectiveness, Side-effects, obstacles

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Artikel online veröffentlicht:
02. September 2024