Montserrat Soler (United States of America)
Cleveland Clinic Women's HealthPresenter of 1 Presentation
FEASIBILITY OF A CERVICAL CANCER PREVENTION PROGRAM IN HAITI WITH SELF-COLLECTED HUMAN PAPILLOMAVIRUS (HPV) SCREENING TESTS AND THERMAL ABLATION TREATMENT (ID 1042)
Abstract
Introduction
Haiti has one of the world’s highest cervical cancer mortality rates. Two non-profit organizations, Basic Health International and Family Health Ministries, in partnership with Haiti’s St. Luke’s Foundation, began a two-year study to determine the feasibility of a screen-and-treat cervical cancer prevention program in urban and rural settings (n=3,000). Patient and provider acceptability data will be collected.
Methods
The study launched April 19, 2019. Women aged 30 to 49 years are recruited in Port-au-Prince (urban) and Tom Gato (rural). Consented women respond to a questionnaire and are instructed in self-collection of a low-cost human papillomavirus (HPV) test (careHPV, Qiagen, Gaithersburg, MD). Women perform self-collection in a private space and subsequently complete an acceptability survey. Screen-positive women return for a pelvic exam and, if eligible, undergo thermal ablation treatment (women ineligible for ablation are referred to colposcopy). Treated women are instructed to return in 1 year for provider-collected HPV re-testing.
Results
To date, the study has enrolled 1,215 women (549 urban, 666 rural). These preliminary data reveal differences between urban vs. rural areas in never having been screened (396/549 [72.13] vs. 533/666 [80%], p<.001) and HPV positivity (96/549 [17.48%] vs. 121/666 [18.16%], p<.001). More urban than rural patients reported willingness to recommend self-sampling to a friend (331/549 [60.29%] vs. 227/666 [34.08%], p<.001).
Conclusions
Urban and rural women in Haiti differ in screening history and HPV positivity. Self-collection of HPV tests was acceptable to over half of urban women but most rural women either did not respond or expressed lower acceptability. The 6 local providers report high acceptability of thermal ablation. Missing data at both sites reflects the challenges of adequate data collection in a low-resource setting; however, the study will shed light on cervical cancer prevention strategies that may be feasible in Haiti.