Evidence map›Paper›PMID 39516742›Full record

ArticleBMC cancer2024

Cervical precancer screening using self-sampling, HPV DNA testing, and mobile colposcopy in a hard-to-reach community in Ghana: a pilot study.

Kofi Effah, Ethel Tekpor, Comfort Mawusi Wormenor, John Allotey, Yaa Owusu-Agyeman, Seyram Kemawor, Dominic Agyiri, Johnpaul Amenu, Jonathan M Gmanyami, Martin Adjuik and 4 more

Abstract read
In one paragraph

Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Kofi EffahCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
Ethel TekporCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
Comfort Mawusi WormenorCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
John AlloteyAllotey and Associates, Lane 14, Alt Lane, Accra, Ghana.
Yaa Owusu-AgyemanmPharma, 22 Garden Road, East Legon, Accra, Ghana.
Seyram KemaworCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
Dominic AgyiriCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana.
Johnpaul AmenuFred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
Jonathan M GmanyamiFred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
Martin AdjuikFred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
Kwabena Obeng DueduSchool of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana.
Joyce B DerFred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
Nana Owusu Mensah EsselCervical Cancer Prevention and Training Centre, Catholic Hospital, Battor, Ghana. nanaowus@ualberta.ca.
Margaret KwekuFred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe World Health Organization has set ambitious goals to eliminate cervical cancer, necessitating evidence on increasing coverage and access to screening and treatment in high-burden areas. We implemented a pilot program to assess the feasibility of obtaining self-collected specimens for high-risk human papillomavirus (hr-HPV) testing in Nzulezo stilt village, a hard-to-reach community in Ghana, and inviting only hr-HPV-positive women to a central location for colposcopy and possible treatment. Subsequently, this study aimed to investigate the prevalence of hr-HPV infection and cervical lesions among the women and to explore factors potentially associated with hr-HPV infection among them.

methodsThis pilot community-based cross-sectional study utilized data from screening sessions held from 2 to 20 November 2021 with specimens collected by participants using Evalyn brushes. HPV DNA testing was performed using the Sansure MA-6000 platform, while visual inspection utilized the Enhanced Visual Assessment (EVA) mobile colposcope. Univariate and multivariable nominal logistic regression was employed to explore factors associated with hr-HPV positivity.

resultsAmong 100 women screened (mean age, 43.6 ± 14.5 years), the overall hr-HPV prevalence rate was 39.0% (95% CI, 29.4-49.3). The prevalence rates of hr-HPV genotypes were stratified as follows: HPV16-8.0% (95% CI, 3.5-15.2), HPV18-5.0% (95% CI, 1.6-11.2), and other genotype(s) - 31.0% (95% CI, 22.1-41.0). Single-genotype infections with HPV16 and HPV18 were found in 4.0% (95% CI, 1.1-9.9) and 3.0% (95% CI, 0.6-8.5) of women, respectively. Mixed infections were observed in 1.0% (95% CI, 0.0-5.4) for HPV16 + 18, 3.0% (95% CI, 0.6-8.5) for HPV16 + other type(s), and 1.0% (95% CI, 0.0-5.4) for HPV18 + other type(s). The prevalence of cervical lesions among hr-HPV-positive women screened via colposcopy was 11.4% (95% CI, 3.2-26.7). In the multivariable model, reliance on other sources for medical bill payment was associated with hr-HPV infection (aOR, 0.20; 95% CI, 0.04-0.93), whereas age was not (aOR, 1.02; 95% CI, 0.99-1.05).

conclusionsA high hr-HPV infection prevalence was recorded among the women. Utilizing technologies such as self-sampling, HPV DNA testing, and mobile colposcopy enables screening and treatment in remote and hard-to-reach communities where access to cervical cancer screening and treatment would otherwise be limited. Further research is warranted to assess the value and scalability of this approach in similar remote areas and its potential implementation in future programs.

Indexed as

ColposcopyEarly Detection of CancerPapillomavirus InfectionsUterine Cervical NeoplasmsAdultCross-Sectional StudiesDNA, ViralFemaleGhanaHuman Papillomavirus DNA TestsHumansMass ScreeningMiddle AgedPilot ProjectsPrecancerous ConditionsPrevalenceDNA, ViralCervical precancerColposcopyHuman papillomavirus DNA testHuman papillomavirus infectionScreeningUterine cervical neoplasmVisual inspection with acetic acid

Identifiers

PMID39516742
PMCPMC11545337

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.