Uptake of community-based, self-collected HPV testing vs visual inspection with acetic acid for cervical cancer screening in Kampala, Uganda: preliminary results of a randomised controlled trial
Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Tropical Medicine and International Health
Abstract
objectives To compare two cervical cancer screening methods: community-based self-collection of
high-risk human papillomavirus (HR-HPV) testing and visual inspection with acetic acid (VIA).
methods Pilot randomised controlled trial of 500 women aged 30–65 in the community of Kisenyi,
Uganda. Women randomised to self-collection-based HR-HPV testing provided a cervico-vaginal
swab for HR-HPV, and results were provided by phone after laboratory testing. Women who tested
HPV positive were referred for VIA at the local health unit. Women randomised to VIA underwent
screening at the local health unit, where women who tested positive with VIA were provided
cryotherapy at time of screening, as per local standard of care. Women were referred for colposcopy
when indicated. Outcome measures were uptake of screening, HR-HPV prevalence, VIA result and
treatment rates.
results In the HR-HPV arm, 248 of 250 (p < 0.01) women provided samples, while in the VIA
arm, 121 of 250 (48.4%) women attended screening. Among the 73 of 248 HR-HPV-positive
women, 45.2% (N = 33) attended VIA screening for follow-up, 21.2% (N = 7) of whom screened
positive; five received treatment and two were missing clinical follow-up records. Of the 121 women
in the VIA arm who attended screening, 13.2% (N = 16) screened positive; seven received
cryotherapy, three refused treatment, five were referred to colposcopy; and one woman had suspected
cervical cancer and received treatment after confirmatory testing.
conclusions This pilot study demonstrated trial feasibility and willingness of the women to
participate and be randomised successfully into the two arms. Self-collection-based cervical cancer
screening had a higher uptake than VIA.
Description
Keywords
human papillomavirus, cervical cancer, screening, community based, self-collection
Citation
Moses, E., Pedersen, H. N., Mitchell, S. M., Sekikubo, M., Mwesigwa, D., Singer, J., ... & Ogilvie, G. S. (2015). Uptake of community‐based, self‐collected HPV testing vs. visual inspection with acetic acid for cervical cancer screening in Kampala, Uganda: preliminary results of a randomised controlled trial. Tropical Medicine & International Health, 20(10), 1355-1367.doi:10.1111/tmi.12549.