Considerations for HPV primary screening in lower-middle income countries

Area of Science:

• Oncology
• Public Health
• Infectious Diseases

Background:

• Cervical cancer remains a significant global health burden, particularly in lower-middle income countries (LMICs).
• Traditional cytology-based screening programs in LMICs face challenges including low sensitivity, quality control issues, and inadequate coverage.
• Human Papillomavirus (HPV) is the primary cause of cervical cancer.

Purpose of the Study:

• To highlight the advantages of HPV primary screening over traditional methods for cervical cancer detection and prevention.
• To emphasize the potential of HPV testing to reduce the global burden of cervical cancer, especially in resource-limited settings.
• To advocate for increased affordability and accessibility of HPV tests in LMICs.

Main Methods:

• Review of accumulated scientific evidence supporting HPV primary screening.
• Analysis of the limitations of cytology-based screening in LMICs.
• Evaluation of the comparative accuracy, reliability, and resource requirements of HPV testing versus cytology.

Main Results:

• HPV primary screening demonstrates superior accuracy and reliability in detecting cervical precancer and preventing cancer.
• HPV testing requires less specialized training, quality assurance, and fewer personnel compared to cytology.
• Implementing HPV primary screening can significantly reduce the global burden of cervical cancer, particularly in LMICs.

Conclusions:

• HPV primary screening is an effective and advantageous strategy for cervical cancer prevention globally.
• Addressing the cost and accessibility barriers of HPV tests is essential for successful implementation in LMICs.
• Sustainable cervical cancer control programs in vulnerable nations necessitate long-term resource commitments for accessible HPV testing.