Ghana has taken significant strides toward addressing the persistent issue of cervical cancer with the implementation of concurrent screening methods across the nation. A recent study has documented the outcomes of this nationwide initiative, marking the effectiveness of combining high-risk human papillomavirus (hr-HPV) DNA testing and visual inspection methods within the framework of an expanded hub-and-spoke model.
Conducted between September 2021 and October 2022 by the Cervical Cancer Prevention and Training Centre (CCPTC) and supported by mPharma’s 10,000 Women Initiative, the study encapsulates the extensive efforts to combat this prevalent disease, which remains the most common gynecological cancer affecting women in Ghana. With cervical cancer accounting for 19.2% of all newly diagnosed cancers, there’s pressing need for effective screening strategies.
The study involved screening 5,217 women—averaging 40.1 years old—across all sixteen regions of Ghana. Among these participants, the overall prevalence of hr-HPV infection was found to be 29.1%. This figure significantly exceeds the WHO-estimated 21.3% hr-HPV prevalence for West African women, underlining the urgent need for widespread screening initiatives.
Key findings reveal regional disparities, with the highest prevalence identified at 32.8% in the Oti Region, contrasting sharply with lower rates of 20.7% seen in both Upper West and North-East regions. The study also discovered various HPV genotypes present, with other hr-HPV types being most commonly detected, constituting 23.5% of infections.
The research method employed was particularly innovative; utilizing the hub-and-spoke model allowed trained health workers to conduct hr-HPV testing and visual inspections within their own communities. Following rigorous training at the CCPTC, these health workers were equipped not only to screen but to counsel and support women through the process, ensuring higher community engagement and retention.
Data collection was facilitated through structured questionnaires, covering demographic factors, testing results, and other clinical histories. Through nominal logistic regression analysis, age below 35 years, non-marital relationship statuses, nulliparity, and HIV positivity emerged as factors significantly associated with increased hr-HPV infection rates.
While women screened displayed significant adherence to treatment follow-up, with the study noting remote supervision as pivotal for maintaining screening quality, it revealed challenges such as transportation of specimens to centralized laboratories. This observation highlights areas for improvement, emphasizing the need for additional hubs equipped for immediate testing.
The CCPTC's engagement with mPharma has proven beneficial, blending local knowledge with international support to create sustainable, community-centric health solutions. "Our concurrent testing approach also had the dual benefit of utilizing both subjective via visual inspection and objective hr-HPV DNA testing methods, thereby improving diagnostic strengths during single visits," the authors of the article noted.
Despite existing hurdles, this initiative signifies the potential for large-scale cervical cancer screening efforts across Ghana, especially as the country works toward establishing organized screening programs. The study concludes with calls for expanded partnerships and long-term funding models, ensuring continuity and access to equitable healthcare for the women of Ghana.