Utilization of HPV DNA testing for screening cervical cancer at primary healthcare level with model of centralised testing and decentralised self-sampling collection

What is the project?

Aligned with the World Health Organization (WHO) ‘s call to action to eliminate cervical cancer, our study aims to provide evidence of the efficiency of HPV DNA testing for cervical cancer screening in real-life settings. By utilizing DNA-HPV testing, we can significantly impact early detection of cervical cancer. Our model involves decentralizing sample collection and centralizing testing in a lab hub, enhancing implementation efficiency and coverage. This approach allows for longer screening intervals, reducing associated costs and resource burden.

Why are we working on it?

Viet Nam has a population of 39.1 million women aged 15 and older who are at risk of developing cervical cancer. Annually, it is estimated that 4,132 women are diagnosed with cervical cancer, and 2,223 succumb to the disease. It ranks as the 8th most frequent cancer among Vietnamese women and the 5th most frequent cancer in those aged 15 to 44.

To combat this, the project focuses on leveraging DNA-based testing for HPV, which has proven more effective than conventional screening methods. The WHO’s Global strategy to accelerate the elimination of cervical cancer underscores the importance of screening coverage with a high-performance test. The published “WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention” in 2021 recommended the use of such DNA-based HPV testing as a first-choice screening method.

What are its objectives?

The project aims to:

  • Catalyze the utilization of HPV DNA testing for mass screening, enhancing early detection and access to cervical cancer treatment through self-sampling.
  • Demonstrate the efficiency of the integrated service delivery model, optimization of decentralization for sample collection and centralization for testing to enable effective scale-up.
  • Generate evidence on the use of the centralized lab model on HPV DNA testing to bolster technical capacity to support MOH in scaling up HPV DNA testing through various models.
  • Support diagnostic capacity building for the management of common diseases at PHC in Viet Nam by providing catalytic support for PHC facilities in access to cervical screening and technical support providing to Provincial Center for Disease Control (CDC) for molecular diagnosis testing.

What does it involve?

The project involves:

  • Establishing processes for screening, diagnostic testing, counselling, and patient management in case of detection.
  • Developing communication programme and providing communication materials, including radio broadcasting, leaflets, and posters, to educate the community.
  • Developing and deploying the YTCS software ( to support healthcare workers with the implementation of the overall project procedure as well as project coordinators with the management of project activities.
  • Organizing on-site training programs for participating healthcare facilities.
  • Procuring and distributing test kits, reagent, and consumables.
  • Providing technical support, monitoring, and evaluation.
  • Implementing sample collection at PHC facilities and HPV DNA testing at provincial CDC.
  • Assessing the feasibility and impact of the model to propose scaling-up plans.

What is the expected outcome?

The anticipated outcomes include:

  • Testing 5,000 women aged 21-65 years without pregnancy for HPV genotype.
  • Educating approximately 500,000 individuals in the catchment area on common diseases prevention and control.
  • Enhancing diagnostic capacity at PHC facilities and CDC for molecular testing with high-performance platform.
  • Evaluating feasibility and acceptability of self-sampling for cervical screening
  • Assessing the impact and scalability of the decentralized self-sampling and centralized lab hub model, as well as sample referral.
  • Providing evidence on the use of the centralized lab model on HPV DNA testing to support WHO’s 90-70-90 target for scaling up HPV DNA testing.
  • Disseminating evidence to the MOH and stakeholders, inclusive of required resources for scale and in support of Elimination roadmap.
  • Producing an assessment report on health service improvement, incorporation of testing into the PHC system, acceptability among healthcare staff and end users, and cost-effectiveness.

What is the time scale?

The project is scheduled to run from June 2023 to December 2023.

Partners and Funding

The project is jointly undertaken by FIND Viet Nam, Hai Phong Provincial Department of Health and CDC in Hai Phong, with funding from Roche.