ideasIdea
Same-day HPV test and heat treatment of precancer by nurses in low-income settings
Where women cannot return for results, test for HPV and treat any precancer the same day with a battery-powered heat probe. This is the fastest route to WHO's cervical elimination target.
WHO recommends HPV DNA testing as the primary screen and thermal ablation for screen-positive women in screen-and-treat settings. Propose nurse-led same-day programmes with point-of-care HPV testing, thermal ablation, and digital tracking, financed through Gavi and Global Fund mechanisms.
Hypothesis
Same-day programmes achieve at least 80% treatment completion of screen-positives (versus under 50% for multi-visit models) and reduce cervical cancer incidence by at least 30% in covered populations within ten years.
Rationale
Loss to follow-up is the largest leak in low-income screening; same-day closes it.
What would test it
Cluster RCT of same-day versus two-visit models in three countries.
Maturity
being tested at scale
Who has to act
policy
Cost to try
Large (over $50M)
Years to first evidence
5
Bottlenecks it attacks
- Prevention we already have is not deployed · Around four in ten cancers are preventable with tools we already own: vaccines, tobacco control, weight, alcohol, sun and infection control.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.