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HPV-based testing and treatment for the elimination of cervical cancer in Papua New Guinea (HPVTATE)

Papua new Guinea

Cervical cancer remains the fourth most common cancer of women worldwide with an estimated 570,000 cases and 311,000 cancer-related deaths annually. It is a disease of inequity with more than 85% of the global burden occurring among women in low- and middle-income countries (LMICs), where HPV vaccination, HPV-based cervical screening, and effective treatment of pre-cancer and cancer, are largely unavailable.

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Background

In 2018, the World Health Organization announced a global call to action towards achieving the elimination of cervical cancer as a public health problem and in 2020, released a draft global strategy that included the ‘90-70-90’ targets to be met by 2030:

  • 90% of girls fully vaccinated with the HPV vaccine by age 15;

  • 70% of women screened with a high-precision HPV test by age 35, and again by age 45 years;

  • 90% of women with cervical pre-cancer treated; and 90% of women with invasive cancer managed. Achieving these targets in the next decade would put countries on the path to achieving elimination in the next century, reduce cervical cancer mortality by 99% and save more than 62 million lives in the next 70-100 years.

Aims

The purpose of this project is to provide the implementation evidence required to inform the scale-up of HPV-based testing and treatment for elimination (HPVTATE) in rural and remote LMIC settings.

We aim to demonstrate that an intervention designed in partnership with women and stakeholders can achieve the WHO 2030 elimination targets for screening and treatment in a cost-effective, acceptable, scalable and equitable manner, our findings will drive the adoption and large-scale implementation of HPVTATE in Papua New Guinea and other Asia-Pacific LMICs.

Project plan

We intend to:

  1. Design a multidisciplinary HPVTATE intervention in partnership with community, district and provincial stakeholders adapted from our evidence-based model. Test implementation of the HPVTATE intervention among women aged 30-59 years in diverse real-world rural district settings in PNG, and evaluate: (a) Reach and (b) Effectiveness

  2. Determine the cost, cost-effectiveness, budget impact of HPVTATE introduction and scale-up.

  3. Evaluate the acceptability of HPVTATE and each of its key components from the perspective of women, their families, health providers and community stakeholders.

  4. Determine facilitators and barriers to scale-up related to local health system, socio-economic, cultural, religious and other contextual factors; and identify strategies for adaptation to other settings, including adoption at scale in PNG.

Principal investigators

  • Karen Canfell The University of Sydney, Australia

  • Andrew Vallely The University of Sydney, Australia

  • William Pomat Papua New Guinea Institute of Medical Research, Papua new Guinea

  • Marion Saville VCS foundation, Australia

  • Rebecca Guy University of New South Wales, Australia

  • Glen Mola The University of Papua New Guinea, Papua new Guinea

  • Julia Brotherton VCS foundation, Australia

  • John Kaldor University of New South Wales, Australia

  • Angela Kelly-Hanku University of New South Wales, Australia

  • Matthew Law University of New South Wales, Australia

Team members

  • Chris Morgan Johns Hopkins Program for International Education in Gynecology and Obstetrics, United States

  • Kate Simms Cancer Council, Australia

  • Michaela Riddell University of New South Wales and Papua New Guinea Institute of Medical Research

  • Lisa Vallely University of New South Wales and Papua New Guinea Institute of Medical Research

  • Steven Badman University of New South Wales, Australia

  • Pamela Toliman Papua New Guinea Institute of Medical Research, Papua new Guinea

  • Josephine Gabuzzi Papua New Guinea Institute of Medical Research, Papua new Guinea

  • John Bolnga Madang Provincial Health Authority, Papua new Guinea

  • Arthur Elijah PNG Obstetrics & Gynaecology Society, Papua new Guinea

  • Suzanne Garland The Royal Women’s hospital, Australia

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