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The Promise of Self-Testing to Prevent Cervical Cancer
By Alicia Banks, Duke Global Health Institute
Pictured above: A group of women listen to education about cervical cancer and screening from a CHV at a health fair in the Gem Sub-County, outside of Kisumu, in Siaya County earlier this year. Credit: Dr. Megan Huchko
Use of a mobile health app developed by Duke researchers and students is expanding in Kenya, allowing more women to screen themselves for the virus that causes cervical cancer.
When Megan Huchko, MD, MPH, Duke Ob/Gyn faculty, Hollier Family Associate Professor of Global Health at the Duke Global Health Institute and director of DGHI’s Center for Global Reproductive Health, began working in Kenya nearly two decades ago, she realized that one of the biggest barriers for women to be screened for cervical cancer was not necessarily the test itself, but where it took place.
She and her team have been working to change that with a mobile health app called mSaada, which allows community health volunteers (CHVs) to facilitate cervical cancer screenings at women’s homes. Launched in 2019, the app has been tested in Kisumu County, home to more than 1 million people. Since the launch of the app, around 25,000 women have been screened for human papillomavirus (HPV) — which if untreated can cause cervical cancer.
“Allowing women to screen via self-collection so they avoid a pelvic exam and have more time for a personalized, accurate screening is women-centered,” said Dr. Huchko. “It’s really great to see this technology in this county.”
Read the full article: duke.is/mSaada
Resident Experience: Global Health Research
As part of her residency research, Nguyên Thảo Thị Nguyễn (Thao), MD, collected data and studied the mSaada app (study period: Oct. 2023 to June 2024).
I became interested in gaining a global perspective on cervical cancer disparities through stories from my mother about life in rural Vietnam, where limited access to health care meant that preventable diseases often went untreated, leading to unnecessary suffering and loss. This deeply resonated with me as I learned about the stark disparities in cervical cancer rates between the Global North and South, largely driven by differences in access to screening and HPV vaccination. The long latency period between HPV infection and cervical cancer offers a unique opportunity for intervention, which inspires me to work toward reducing these disparities through innovative solutions.
Recognizing diverse approaches to screening and treating cervical dysplasia is essential for adapting interventions to the specific challenges of low-resource settings. In these areas, barriers to receiving results and attending follow-up appointments become significant obstacles to completing the cervical cancer screening cascade. Tailoring approaches ensures that screening programs are not only effective but also practical and accessible within the constraints of the setting. Cultural norms further shape how care is accessed and accepted, which should be taken into account to ensure that screening strategies are culturally appropriate.”
Read the full article: duke.is/GHE2024