Cervical Cancer Screening by Self-sampling in a Cohort of Younger Women in Ethiopia

Evaluation of an Human Papillomavirus (HPV) Based Screening Algorithm for Low and Middle Income Countries, by Self-sampling in Ethiopia

Addis Ababa University, Armauer Hansen Research Institute, Ethiopia, Adama Hospital Medical College, Ethiopia

The overall purpose of the project is to evaluate an algorithm for an HPV self-sampling based cervical cancer screening algorithm in a mid-size town in Ethiopia that could be applicable for nationwide implementation in low and middle-income countries (LMIC). Specific aims are the following: To evaluate the algorithm using Visual Inspection with Acetic acid (VIA) and VIA together with Lugol's Iodine (VILI) as triage and to use HPV self-sample to follow up those treated and those with persisting HPV. To evaluate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae and their effect on the quality of VIA. To determine immune response profiles in high-risk HPV-positive women who cleared, persisted, or developed Cervical Intraepithelial Neoplasia 2/3 (CIN). To assess how specific cervicovaginal microbiota compositions are associated with HPV infection, cervical dysplasia, and cancer

The whole cohort is offered an HPV self-sample. The HPV high risk positive women gets randomised into two arms VIA or VIA/VILI at the triage step.

A triage test that involved a gynaecological exam that applies acetic acid and then Lugol's iodine on the surface of the external os of the cervix.

A triage test that involved a gynaecological exam that applies acetic acid on the surface of the external os of the cervix.

Chlamydia Trachomatis, Neisseria Gonnorhea, Ureaplasma Urelytikum/Parvum, Trichomonas Vaginalis, Mycoplasma Genitalium/Hominis

Inclusion Criteria: Can give consent, Age above 18 Exclusion Criteria: Women who have undergone hysterectomy