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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The Mulher Study: cervical cancer screening with primary HPV testing in Mozambique
International Journal of Gynecological Cancer, Volume 33, No. 12, Year 2023
Notification
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Description
Objective To evaluate cervical cancer screening with primary human papillomavirus (HPV) testing in Mozambique, a country with one of the highest burdens of cervical cancer globally. Methods Women aged 30-49 years were prospectively enrolled and offered primary HPV testing using either self-collected or provider-collected specimens. Patients who tested positive for HPV underwent visual assessment for treatment using visual inspection with acetic acid to determine eligibility for thermal ablation. If ineligible, they were referred for excision with a loop electrosurgical excision procedure, for cold knife conization, or for cervical biopsy if malignancy was suspected. Results Between January 2020 and January 2023, 9014 patients underwent cervical cancer screening. Median age was 37 years (range 30-49) and 4122 women (45.7%) were patients living with HIV. Most (n=8792, 97.5%) chose self-collection. The HPV positivity rate was 31.1% overall and 39.5% among patients living with HIV. Of the 2805 HPV-positive patients, 2588 (92.3%) returned for all steps of their diagnostic work-up and treatment, including ablation (n=2383, 92.1%), loop electrosurgical excision procedure (n=169, 6.5%), and cold knife conization (n=5, 0.2%). Thirty-one patients (1.2%) were diagnosed with cancer and referred to gynecologic oncology. Conclusion It is feasible to perform cervical cancer screening with primary HPV testing and follow-up in low-resource settings. Participants preferred self-collection, and the majority of screen-positive patients completed all steps of their diagnostic work-up and treatment. Our findings provide important information for further implementation and scale-up of cervical cancer screening and treatment services as part of the WHO global strategy for the elimination of cervical cancer. © 2023 BMJ Publishing Group. All rights reserved.
Authors & Co-Authors
Pontremoli, M. M.B.
United States, Houston
The University of Texas Md Anderson Cancer Center
Lathrop, Eva H.
United States, Washington, D.c.
Population Services International
Osman, Nafissa Bique
Mozambique, Maputo
Universidade Eduardo Mondlane
Neves, Andrea
Mozambique, Maputo
Hospital Geral José Macamo
Rangeiro, Ricardina
Mozambique, Maputo
Hospital Central de Maputo
Mariano, Arlete A.N.
Mozambique, Maputo
Hospital Geral de Mavalane
Carrilho, Carla
Mozambique, Maputo
Universidade Eduardo Mondlane
Monteiro, Eliane C.S.
Mozambique, Maputo
Hospital Geral de Mavalane
Carns, Jennifer L.
United States, Houston
Rice University
Andrade, Viviane
Ireland, Dublin
Icon Plc
Mavume, Celda
Mozambique, Maputo
Ministério da Saúde de Moçambique Misau
Atif, Hira
Mozambique, Maputo
Ministério da Saúde de Moçambique Misau
Chissano, Marcos
United States, Washington, D.c.
Population Services International
de Oliveira, Cristina Mendes
Unknown Affiliation
Lopez-Varon, Melissa
United States, Houston
The University of Texas Md Anderson Cancer Center
Baker, Ellen S.
United States, Houston
The University of Texas Md Anderson Cancer Center
Jerónimo, José A.
United States, Rockville
National Cancer Institute Nci
Castle, Philip E.
United States, Rockville
National Cancer Institute Nci
Richards-Kortum, Rebecca Rae
United States, Houston
Rice University
Schmeler, Kathleen M.
United States, Houston
The University of Texas Md Anderson Cancer Center
Lorenzoni, Cesaltina Ferreira
Mozambique, Maputo
Ministry of Health Mozambique
Statistics
Citations: 1
Authors: 21
Affiliations: 11
Identifiers
Doi:
10.1136/ijgc-2023-004958
ISSN:
1048891X
Research Areas
Cancer
Infectious Diseases
Study Design
Cohort Study
Study Locations
Mozambique
Participants Gender
Female