Côte d’Ivoire expands cervical cancer screening with successful self-testing program

IVORY COAST— The Ministry of Health of Côte d’Ivoire has successfully expanded self-testing for cervical cancer screening, with nearly 90% of screenings now conducted through this method.

This approach empowers women to take charge of their health, offering a private and convenient way to detect the disease early.

Cervical cancer is the leading cancer affecting women in Côte d’Ivoire, with a staggering 2,360 new cases recorded in 2022 and a mortality rate of 62%.

 However, it is preventable through vaccination and can be effectively treated if detected early.

The high mortality rate is mainly due to late diagnosis, limited access to treatment, complicated pre-therapeutic care pathways, and a general lack of awareness about the disease, as explained by Dr. Simon Boni, lead researcher at the National Cancer Control Programme (PNLca).

In 2019, the government of Côte d’Ivoire launched the Scale Up Cervical Cancer Elimination with Secondary Prevention Strategy (SUCCESS), supported by the World Health Organization (WHO) and UNITAID.

This initiative aims to eliminate cervical cancer as a public health concern in Côte d’Ivoire and Burkina Faso.

 Two years ago, self-testing was integrated into the national strategy, significantly improving access to screening, particularly for women living with HIV, who are six times more likely to develop cervical cancer.

Between 2021 and 2023, over 40,000 women were screened through the SUCCESS project across four health regions: Abidjan 1 and 2, Gbèkè, and Haut-Sassandra.

 Initially, in 2022, 51% of women attending health centers that offered self-testing opted for this method; however, by 2023, this figure had risen to 90%.

Self-testing has increased confidence and comfort among women, while reducing cultural barriers to screening.

Health providers also prefer self-testing due to heavy workloads, as it saves time that can be used for essential program monitoring.

At Saint Camille Hospital in Bouaké, which specializes in care for people living with HIV, the Ministry of Health, with WHO support, has implemented a secondary prevention strategy focused on HPV screening.

 The Ministry has trained 20 health professionals in community outreach, HPV testing, visual inspection after application of acetic acid (VIA), and treatment using thermal ablation.

Within three months, the trained team supported 46 women living with HIV to use the HPV self-sampling test.

Dr. Françoise Milolo noted that self-testing allowed for early detection and timely treatment in some patients.

The number of health facilities offering self-testing services has grown from 34 to over 200, boosting women’s confidence and encouraging greater uptake of screening.

 Early detection remains a crucial strategy in fighting cancer among women, as emphasized by Agnès Diasso, a midwife and cervical cancer screening provider.

Many women have avoided premature death thanks to the identification and treatment of precancerous lesions.

WHO continues to support Côte d’Ivoire in developing strategies to accelerate the elimination of cervical cancer, aiming to reach 70% of eligible women by 2030.

The country’s model, particularly for reaching women living with HIV, represents a promising approach to scaling up screening.

As Dr. Fatim Tall, Programme Coordinator at WHO in Côte d’Ivoire, noted, integrating HPV tests into the national program makes self-sampling a powerful complementary option, as many women feel more comfortable collecting their own samples.

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