Cervical cancer screening in Sub-Saharan Africa: A scoping review of test and treat and test, triage and treat approaches
Esteire et al.
The finding, in our words
This scoping review synthesised evidence that HPV-based cervical screening using vaginal self-sampling and single-visit models improves coverage and reduces loss to follow-up in Sub-Saharan Africa, with thermal ablation proving a feasible treatment. These patient-centric approaches are critical for sustainable cervical cancer elimination in low-resource settings.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
This meta-analysis found that HPV testing using self-collected vaginal and urine samples showed sensitivities of 88.6% and 81% for detecting cervical precancer. Using a standardised device for first-void urine increased sensitivity to 86.6%, supporting decentralised patient-centric screening, though data on specificity and specific commercial devices were not consistently reported.
Hsiao et al., The journal of obstetrics and gynaecology research (paywalled) · source ↗
DNA methylation markers in first-void urine effectively detect high-grade cervical lesions in HPV-positive women, with results similar to clinician-collected samples in those over 30. This enables reliable cervical cancer screening using self-collected urine, reducing the need for invasive follow-up procedures in decentralised settings.
A study of 2500 women found 99.0% agreement between first-void urine and vaginal self-sampling for HPV detection using Cobas4800, with 98.1% of participants preferring urine. Although conducted in a resource-limited setting which may limit generalisability, these results support urine as a viable sample type for decentralised, patient-centric screening.
This study found that self-collected vaginal swabs and first-void urine yielded comparable detection rates for vaccine-targeted high-risk HPV types, supporting the use of both patient-centric methods for decentralised surveillance. Vaginal swabs showed higher sensitivity for non-vaccine types, whereas urine sampling offers a non-invasive alternative.
First-void urine and self-collected vaginal swabs showed similar sensitivity and specificity to clinician-collected cervical samples for high-risk HPV detection across two real-time PCR assays, supporting their use as decentralised, patient-collected alternatives; most women preferred first-void urine for regular cervical screening.
A et al., Journal of gynecologic oncology (paywalled) · source ↗