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Experts call for shift in cervical cancer screening

By Ally Jamah | Published Wed, March 8th 2017 at 12:44, Updated March 8th 2017 at 13:49 GMT +3
Dr Ahmed Kalebi, a Kenyan Consultant Pathologist and CEO of Lancet Group of Labs at the just concluded International Papillomavirus Conference (HPV 2017) in Cape Town, South Africa together with Meindert Zwart, President & CEO Rovers Medical Devices. Some experts have called for a shift to HPV testing in combating cervical cancer.

A growing number of local and international experts are calling for a shift in cervical cancer screening to save more lives of women in Kenya and other countries. 

Researchers from Kenya and elsewhere at the just concluded 31st International Papillomavirus Conference (HPV 2017) in Cape Town, South Africa want HPV testing to be the first choice for cervical cancer screening instead of pap smear (PS) and Visual Inspection with Acetic acid (VIA), which are common in Kenya.

HPV testing identifies the sexually-transmitted Human Papilloma Virus (HPV) that triggers almost all cases of cervical cancer, unlike the two other methods which focus on detecting abnormal changes on the cervix associated with the disease.

HPV positive women have higher risks of developing cervical cancer and need closer monitoring than HPV negative women.

“Some countries, including United Kingdom, Netherlands, Australia and New Zealand have switched to HPV testing as the first tool of choice to screen for cervical cancer to help narrow down to women who have the highest risk of getting the disease,” said Dr Ahmed Kalebi, a Kenyan Consultant Pathologist and CEO of Lancet Group of Labs who participated in the conference.

The University of Nairobi Honorary Lecturer added: “In many other parts of the world, HPV testing is also getting incorporated into cervical cancer screening programmes, including in USA, South Africa, China.”

Cervical cancer is a major concern in Kenya since it is the second most common cancer among Kenyan women and is top in terms of causing deaths.

HPV testing is not widely available in Kenya. The only approved HPV testing equipment to replace pap smear called Cobas HPV was introduced in Kenya in August last year.

Participants suggested that HPV testing should be incorporated into public health programmes financed by the government to combat the growing cases and deaths related to cervical cancer.  The method can be easily scaled up to screen more women since it is automated.

Some studies presented at the conference showed HPV to be cost-effective even in low resource settings such as Kenya.

A study involving 517 HIV positive in Eldoret by researchers from Moi University and USA concluded that HPV testing is feasible in that low-resource setting compared to pap smear and VIA.

Another study in India, Uganda and Nicaragua looking into cost-effectiveness of cervical screening methods in middle and low countries found HPV to be cost-effective and appropriate.

In 2013, the World Health Organization (WHO) had also issued guidelines on cervical cancer screening, in which HPV Testing was recognised as a preferred method for cervical cancer screening programs.

Recently, the American Society for Clinical Oncology (ASCO) recommended HPV testing as the primary screening tool of choice for cervical cancer even for low-resource settings. It suggested that women may be screened one to three times in their lifetimes.

HPV testing is seen as more cost-effective in the long-run since women who are found to be HPV negative do not need to be retested till 5 to 10 years later, unlike PS in which women may need retesting yearly.

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