Community-Based Specimen Collection And HPV Testing For Cervical Cancer Screening; Lessons From A Cross-Sectional Study In Ghana

Adolf AWUA, Radiological and Medical Sciences Research Institute, GAEC, Ghana
WIREDU E. 4, 5 , AFARI E. 2 , TIJANI A. 6 , ADANU R. 3

1 Cellular and Clinical Research Centre, Radiological and Medical Sciences Research Institute GAEC, Accra, Ghana
2 Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana
3 Population, Family and Reproductive Health, University of Ghana School of Public Health, Accra, Ghana
4 University of Health and Allied Sciences, Ho, Ghana
5 Department of Pathology, University of Ghanas School of Biomedical and Allied Health Science, Korle-Bu, Ghana
6 Akuse Government Hospital, Ghana Health Service, Akuse, Ghana

Background: The implementation of existing cervical cancer screening strategies has reported different rates of success in different countries. These have been mainly due to the experience of different factors including population specific factors that limit women’s participation. We report observations and the development of a community-based specimen collection approach as a result of interactions with women in the study communities following an initial low response to a cervical cancer screening activity.
Method: In this cross-sectional study, women were initially recruited by a household survey and invited to report at a hospital either within a week or after a week for self-specimen and health personnel specimen collections. However, due to low reporting rate and an interaction with women, another approach was developed that required recruited women report at a central location within their respective communities for both specimen collections.
Results: Of the 174 participants who opted to report after a week (long duration group) for specimen collection at the hospital, 49 (37.9%) reported. Of the 100 participants who opted to report within 1 week (short duration group) for specimen collection at the hospital, 53 (53.0%) reported. Of the 103 participants were invited to report at a specified location within the community (instead of the hospital) for specimen collection, 99 (96.1%) reported. An overall response rate of 60.7% was attained. Although almost 90.0% of the owmen performed both self and health personnel sample collection, post-performance preference for health personnel sample collection was higher (55.9%) than for self-sample collection (22.4%).
Conclusion: A community-based approach with self-specimen collection and HPV testing holds great potential for increasing women participation in cervical cancer screening in Ghana and other  developing countries. The patterns of the distribution of the risk factors are suggestive of a potentially high HPV prevalence for this community.