A Community-based HPV screening implementation in Low-Income countries

ongoing

Cervical cancer is the 4th most common cancer in women worldwide, with up to 85% of the burden in resource-restricted countries. Early detection of precancer has shown to be successful in reducing cancer incidence and mortality. However, a global implementation of this approach is hampered by culture and resource differences between countries. We propose to evaluate the acceptability, feasibility and cost-effectiveness of the ELEVATE cervical cancer screening tool in low-income countries (LIC). The tool is a portable, battery-powered device compatible with self-sampling and comprises an HPV DNA test as well as a proteomic biomarkers detection sensor and will be offered to women in Ethiopia, Cambodia, Mozambique and Uganda. This multidisciplinary consortium, led by Ghent University (Belgium), brings together social scientists, health economists and biosensor experts from Europe and the selected countries with industry partners. The approach is three-fold: social science investigations will be conducted to understand current screening practices and to define a tailored strategy, including the ELEVATE tool, embedded in the current health system. Secondly, engineers will validate the self-testing device and will adapt it to reduce the unit price and to enable large-scale manufacturing at an affordable cost. Finally, public health specialists and health economists will evaluate the implementation of the new screening tool to assess its appropriateness and cost-effectiveness. For the latter objective, an intervention will be implemented: in the first arm, the different steps of current cervical cancer screening practices will be optimized (awareness, pre-and post-counseling and referral). In the second arm, the same strategy will be applied in combination with the new point-of-care screening device. Integral part of CHILI is to maximize the use of the new screening tool in low-resource settings in collaboration with national stakeholders and health care providers.