Background
The ASPIRE project (Advances in Screening and Prevention in Reproductive Cancers) is a novel approach to cervical cancer screening that is effective, low-cost, acceptable, and ideal in low-resource settings. ASPIRE aims reduce the global burden of cervical cancer through its cost-effective, community-based model of cervical cancer screening that focuses on capacity building in local communities.
The ASPIRE team, comprised of researchers from the BC Centre for Disease Control, BC Women’s Hospital & Health Centre, University of British Columbia, BC Cancer Agency, and Makerere University in Kampala, recently published their pilot findings from a community-based cervical cancer screening program in Uganda.(1)
Pilot study
The pilot study was conducted in 2011 in Kisenyi, Uganda to determine the acceptability, uptake and outcomes of a community-based HPV self collection program. Women between the ages of 30 and 69 were approached by a local outreach worker at their homes and in community gathering places and were asked to provide a self-collection specimen. Of the women 205 women enrolled in the study, 199 provided a specimen, with a self-collection method acceptability of 97%.
Self-collected specimens were tested for HPV and reproductive tract infections as part of the screening program. Women who tested positive for HPV were followed up by phone and invited for a visual inspection assessment and colposcopy. Women with visible lesions at colposcopy were treated with cryotherapy in the same follow-up visit. Over 85% of the women with positive results were successfully followed up.
Implications for practice
ASPIRE is unique in its integrated approach to screening, which involves self-collection, HPV testing, and colposcopy follow-up, while including training, capacity building, and community engagement in its reproductive health care service provision model.
The pilot findings suggest that a community-based reproductive screening program that uses self-collected specimens for HPV is both acceptable and feasible in this low-resource community in sub-Saharan Africa. The ASPIRE model has important implications that could help inform global policy on cervical cancer screening recommendations and practice in low-and-middle income countries, or other low-resource settings.
Knowledge translation
The ASPIRE team has created a 23-minute documentary film (When a Mother Lives) which tells the story of this innovative cervical cancer screening program from the experience of the women in Uganda involved in the study.
ASPIRE also recently redesigned its website to improve its utility as a knowledge translation tool. The new website includes:
- Information on ASPIRE and cervical cancer
- Links to partner organizations and social media
- Key publications from the project
- ‘When a Mother Lives’ documentary
- An online donation feature
To watch the video, or for more information about the ASPIRE project & publications please visit the new website.
References
- Ogilvie G S, Mitchell S, Sekikubo M, Biryabarema C, Byamugisha J, Jeronimo J, Miller D, Steinberg M, Money D M. Results of a community-based cervical cancer screening pilot project using human papillomavirus self-sampling in Kampala, Uganda. Int J Gynaecol Obstet 2013; 122 (2): 118–123.