Cervical cancer screening feasibility study MorocOncoE6 comparing VIA with molecular HPV oncogene expression testing

Background:

Visual inspection with acetic acid (VIA) is the standard cervical cancer screening in Morocco. OncoE6 Cervical Test (Arbor Vita, CA, USA) is an oncoprotein-based lateral flow assay designed for dysplasia detection. MorocOncoE6 is a pilot study to compare screening methods and their acceptability.

Methods:

200 women were recruited in health posts and a swab sample, a cytobrush and a home-taken self-sample (Evalyn brush, Rovers Medical Devices, The Netherlands) was obtained. Questionnaires were used to inquire acceptability. All women got colposcopy and biopsy for histology in a reference center. HPV genotyping was performed.

Results:

A screening cohort of 200 women living in rural (100) or urban (100) area in Tangier was recruited from 25.12.17 till 07.03.18. Participation rate was 89%. All participants provided self-collected and two clinician-collected specimens and underwent VIA. OncoE6 Cervical Test was done for the self-collected and physician-collected swab. 31 women had positive VIA and 6 women a positive OncoE6 Cervical Test. Women judged self-sampling as easy and preferable. HPV genotyping data and histology (7 low grade dysplasia, 27 HPV infection signs, 2 squamous cells metaplasia were found) data and questionnaires (knowledge of cervical cancer, socio-demographic characteristics, medical history and acceptability of the Evalyn® brush self-collection) will be correlated to screening test results.

Conclusion:

This feasibility trial establishes technical and logistical prerequisites, and preferably acceptable and efficient screening tools in the Moroccan cervical cancer screening program. Self-sampling is well accepted. The 6 fold higher referral rate after VIA is problematic for the overburdened healthcare system.