Implementation of a cervical cancer screening programme using a 3T-Approach in low-and Middle income countries


Jessica Di Vincenzo-Sormani

Cervical cancer is a leading causes of cancer death in women in low-and middle-income countries (LMICs). Since 2020, and the call for action released by the World Health Organization (WHO) to eliminate cervical cancer, this burden has become an international priority(1). In order to achieve elimination, the WHO has set the “90-70-90 targets”: 90% of the target population vaccinated, 70% screened, 90% treated. Thanks to a strong collaboration between Cameroon and the University Hospitals of Geneva for many years, a five-year project (2018-2023) to fight against cervical cancer has been implemented at the Dschang District Hospital (DDH), in the West Region of Cameroon This project was based on WHO strategies and follows a "screen-triage-treatment" (3T) procedure, i.e. targeting women aged between 30 and 49 years. This approach is recommended for LMICs. To date, the implementation of such a prevention project in Cameroon has not been evaluated. In order to make the project sustainable and to replicate it in different areas of Cameroon, an evaluation of the 1) feasibility, 2) safety and 3) acceptability of this approach and its procedures has been conducted since the launch of the project. The results of the evaluation of the implementation of the 3T screening project showed that the recommended practices are adapted to the local context and are embedded in a sustainable approach. Patient safety was not impacted by the various interventions and treatments offered by the project. In general, the 3T-Approach and the interventions carried out during screening, triage and treatment were well accepted by the women, who mostly reported that they would recommend them to others. Based on these results, the 3T project will continue to implement the WHO recommendations for cervical cancer screening in the local context, and will maintain quality control in order to quickly propose strategies for improvement when necessary In 2022, the project will expand and open new screening facilities at the Bafoussam Regional Hospital. Our prior experience gained from the development of this 3T project will allow us to upscale this feasible, safe and acceptable cervical cancer prevention program in order to reach other women in need.