Abstract B103: Community-based uptake of self-sampling for HPV DNA-based testing for cervical cancer screening in Ethiopia: Preliminary findings of a cluster randomized trial

Abstract

Abstract Background: Cervical cancer (CC) remains a leading cause of morbidity and mortality of all cancers among women residing in low-income countries, including Ethiopia. In Ethiopia, although the standard method of CC screening is using Visual Inspection with Acetic Acid (VIA), service accessibility is limited and the uptake by eligible women is very low. Self-sampling for human papillomavirus (HPV) DNA testing might improve the uptake of targeted women for CC screening, especially for hard-to-reach population in Ethiopia. We investigated whether self-collection of cervicovaginal samples for HPV DNA tests would be associated with increased uptake of screening compared with VIA. Methods: A community-based randomized controlled trial has been conducted in Butajira, one of the Health and Demographic Surveillance Sites (HDSS) of Ethiopia. A total of 55 clusters comprising 2,356 women aged 30-49 were randomized in two arms. Community-based sensitization was conducted using the local community workers at their vicinity. Following the community mobilization women were invited to go to the local health post for self-collection-based HPV DNA testing (arm A) or to Butajira Hospital for VIA screening (arm B). We compared the uptake of screening between the two arms. Results: In the HPV arm, of the total 1,213 sensitized women, 1,020 (84.1%) (P<0.0001) accessed the health post for HPV screening. In the VIA arm, 575 of 1,143 (50.5%) visited the hospital. Among the women who accessed the health post for HPV DNA testing, 892 of 1,020 (87.5%) (p=0.0007) provided samples, while 466 of 575 (81%) underwent VIA screening. The residual was excluded due to eligibility criteria in both arms. Conclusion: This preliminary finding of the trial demonstrated better community acceptability and uptake of self-collection-based CC screening at the health post compared to VIA at the hospital. Self-collection-based CC screening can be done at the local health facility and may significantly improve the uptake of CC screening in Ethiopia. Citation Format: Muluken Gizaw, Friederike Ruddies, Adamu Addissie, Alemayehu Worku, Tamrat Abebe, Brhanu Teka, Andreas M. Kaufmann, Eva Kantelhardt. Community-based uptake of self-sampling for HPV DNA-based testing for cervical cancer screening in Ethiopia: Preliminary findings of a cluster randomized trial [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B103.