Cervical Cancer Screening via Self-Sampling for High-Risk Human Papilloma Virus: A Community-Based Pilot Study in Lagos, Nigeria

Abstract

Background: Cervical cancer is the second most common cancer in women globally after breast cancer. It is a preventable cancer with a well‑defined premalignant phase where treatment could be offered before invasive cancer develops. Objective: To determine the prevalence, socio-demographic characteristics and serotypes of high-risk HPV amongst positive women using self-sampling HPV-based cervical cancer screening. Methods: A cross-sectional pilot study in an urban setting in Lagos, Nigeria where one hundred women, following community-based counselling on cervical cancer and its prevention, underwent cervical cancer screening via self-sampling for hr-HPV. Structured questionnaires were administered for data collection. Appropriate instruction for self-sample collection using Flobam cervical sampling kit was given to each subject. The samples were processed using DNA analysis via PCR (polymerase chain reaction) amplification and flow through hybridization to identify the hr-HPV serotypes. Women who tested positive for hr-HPV had colposcopic-guided biopsy. The data obtained were analysed using SPSS version 20.0. Findings: Almost all (97%) the women were successful at self-sampling. The prevalence of hr-HPV positivity was 19% with peak (31.6%) of hr-HPV positivity observed in subjects aged 31-40 years. HPV 53 was the commonest (36%) serotype, HPV 33 and 39 were the least (7%) identified and 47% of hr-HPV positive subjects had infection with two or more HPV serotypes. Two-third (66.7%) of hr-HPV positive subjects attended follow-up for colposcopy guided biopsy and 10.5% of the hr-HPV positive subjects had premalignant/malignant cervical lesion. Conclusion: Infection with more than one hr-HPV serotype is common in our study. Self-sampling modality of HPV cervical cancer screening is feasible in this environment.