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
