HPV self-testing a game-changer for cervical cancer screening

HPV infection in the genitals can cause cancer of the cervix or vagina in women or cancer of the penis in men. [iStockphoto]

According to the World Health Organisation, globally, cervical cancer ranks as the fourth most frequently diagnosed cancer and the fourth leading cause of cancer death in women and yet it is a preventable disease. The WHO has a global strategy to eliminate cervical cancer.

To achieve this, the following targets must be met by 2030 for countries to be on a path to eliminate the disease; 90 per cent of girls should fully vaccinated with the HPV vaccine by the age of 15 years, 70 per cent of women screened by the age of 35 and 90 per cent of women identified with the disease should receive treatment.

The Human Papillomavirus (HPV) is a common virus that is associated with ano-genital cancer. Normally, people are infected with HPV if their genitals or mouths touch the genitals of someone infected with the virus. HPV can also be spread by close genital-to-genital touch.

HPV infection in the genitals can cause cancer of the cervix or vagina in women or cancer of the penis in men. Other types of HPV can cause genital warts in women and men. HPV infection also causes anal cancer and oral cancer in both women and men.

HPV test is a screening to detect the presence of high-risk HPV types that are most likely to cause cervical cancer. This test is done alone as a primary HPV screen or at the same time with a Pap smear test. This is called a co-test. This can be done either by a healthcare worker or patients in the comfort of their own homes using a special brush to collect the sample.

Primary HPV test is the recommended screening method for women between ages of 30 and 65 years every five years in HIV-negative women and every three years in HIV-positive women as per the Ministry of Health and national cancer screening guidelines. The test is available only to women. No test exists to detect the virus in men.

If high risk HPV is found, then a Pap smear test will be collected to look at cell changes. If there are no changes, then your doctor will ask you to return in one year to make sure the HPV has cleared. If high-risk HPV and cell changes are seen, then you will undergo further tests.

Early detection of the virus improves the chances of successful treatment of pre-cancers and cancers. Women have the option of a self-test when compared to other modalities for screening cervical cancer and this might improve the uptake of screening. Women with a negative test can be confident that they are at very low risk of developing abnormal cells that may lead to cervical cancer within the next five years when they will test again.

-Dr Khadija is a Consultant Gynaecologic Oncologist, Department of Obstetrics and Gynaecology, Aga Khan University Hospital Nairobi