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HPV self-testing with same-day treatment as the national cervical programme

Women can collect their own sample for the virus that causes cervical cancer; those who test positive can be treated the same day with a simple heat device. Done nationally, this could eliminate a disease that still kills hundreds of thousands of women a year.

WHO's cervical cancer elimination strategy sets 70% screening coverage with a high-performance test and 90% treatment of pre-cancer. Self-collected HPV testing removes the speculum exam that deters women, and portable thermal ablation allows treatment at the point of screening without histology. Point-of-care HPV tests now return results within an hour. The proposal is to make this combination, rather than cytology, the default national programme and fund it as a vertical campaign.

Hypothesis
Countries implementing self-sampling plus same-day ablation will reach 70% screening coverage of women aged 35-45 within five years, versus under 20% for cytology-based programmes, and will halve pre-cancer treatment loss to follow-up.
Rationale
Self-sampling roughly doubles participation in trials in Africa and Latin America; screen-and-treat eliminates the second visit that loses most patients.
What would test it
National rollout with population coverage, positivity, same-day treatment rate, and cervical cancer incidence tracked in the population-based registry over ten years.
Maturity
being tested at scale
Who has to act
policy
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks

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