Project overview
Cervical cancer is a major public health problem, with annually more than 500.000 women worldwide diagnosed with this disease. The Prevention and Screening Innovation Project toward Elimination of Cervical Cancer (PRESCRIP-TEC) contributes to effective and innovative cervical cancer screening, including direct treatment for women in resource-poor or hard-to-reach settings in the world.
PRESCRIP-TEC conducts implementation research in four countries over three continents: Bangladesh and India in Asia, Uganda in Africa, and Slovakia in Eastern Europe. We will improve existing screening protocols in the four countries. In this research universities, cancer institutes and non-governmental organisations from these countries collaborate with the University Medical Center Groningen and the Female Cancer Foundation in the Netherlands.
Better Communication
We will improve interactive information with communities via traditional media, mobile devices and social media. At this moment, in most hard-to-reach areas women are approached through radio, face-to-face meetings, flyers, posters, etc. This results in limited uptake of cervical cancer screening in many populations.
All over the world, the use of mobile devices, social media, and modern communication technology is spreading quickly. Also women with limited health literacy or limited internet access, are using the technology more and more. PRESCRIP-TEC will investigate to which extent the range of social mobilisation options can be expanded for prevention and screening of cervical cancer.
Better testing for HPV
Nearly all cervical cancers are caused by infection with the Human Papilloma Virus (HPV). The Word Health Organisation recommends HPV testing as the primary screening intervention.
We will offer client-friendly HPV self-tests at home. Women do not have to travel to a clinic for gynaecological examination, to know if they have a HPV infection. Only those women who are HPV positive will be invited for further investigation.
Artificial Intelligence
In India, Bangladesh and Uganda HPV positive women will undergo a Visual Inspection of the cervix with Acetic acid (VIA) in mobile clinics or primary healthcare facilities, to diagnose any precancerous lesions, which need treatment.
We will use an artificial intelligence decision support systems (AI-DSS) in gynaecological examination. The use of artificial intelligence built into mobile devices offers high quality diagnosis in resource-poor settings. Inter-observer variation in VIA will be reduced.
Immediate treatment
We will offer to women who need treatment for precancerous lesions direct treatment in the location where the VIA is performed. This reduces travel time and therefore drop-out of women in the process.
Research
We will analyse the uptake of cervical cancer screening offered. Will improved communication lead to higher attendance? Will convenient HPV testing at home lead to higher acceptance? Will AI-DSS lead to better diagnosis?
We will perform a cost-effectiveness analysis and a produce a business case for the global introduction of hrHPV testing as routine screening for cervical cancer. We will show the advantage of point-of-delivery testing and the benefits of self-testing for cancer in the post-COVID era, which reduces pressure on the health system. This research, therefore will be a major contribution in supporting the global WHO strategy for elimination of cervical cancer.