Although cervical cancer is now a vaccine-preventable disease, 1 woman dies every 2 minutes globally of cervical cancer. Women in low- and middle-income countries are disproportionately affected.

In South Africa (SA), over 10,700 new cases of cervical cancer are diagnosed each year, with over 5,800 deaths. Cervical cancer is a preventable tragedy, and South Africa has the tools and knowledge to turn the tide. 

We can eliminate cervical cancer by addressing the principal cause: the human papillomavirus or HPV. This is done by 1) vaccinating both boys and girls between the ages of 9 and 15; and 2) expanding access to HPV screening for all women. Screening for early diagnosis is critical because when diagnosed early, cervical cancer is considered treatable/curable. 

SA is making significant strides in expanding access to both vaccination and screening, but significant barriers remain. Dr Ifedayo Adetifa, CEO of FIND (https://apo-opa.co/4jMkyJA), whose mission is #DiagnosisForAll says, “The fight to eliminate cervical cancer is far from over, but there is hope on the horizon. FIND is working with the public and private sectors in South Africa to find innovative and scalable solutions to test for HPV”.  

Recent research by FIND and partners provides critical insights that could transform how we approach cervical cancer prevention and management. The project explored the acceptability and demand for HPV self-collection testing among South African women as a means of increasing access to HPV screening. 

Key findings from the client surveys include 

1. Low Awareness of Cervical Cancer and HPV: 

• 58% of women surveyed had little or no knowledge about cervical cancer or its link to HPV. 
• 46% cited nurses and doctors as their primary sources of information, showing the critical role healthcare providers play in education. 

2. HPV DNA Testing: The Preferred Choice: 

• 77% of respondents chose HPV DNA testing as their preferred method, valuing its reliability and less invasive nature. 
• Among these, 71% preferred self-collection, citing privacy and convenience as the main reasons for their choice. 

3. Pharmacy Accessibility: 

• 74% of women who preferred self-collection indicated they would purchase kits from pharmacies. 

4. Affordability and Willingness to Pay: 

• Most respondents indicated that a price point between $18 and $36 would make the test more accessible. 

5. Home vs Clinic Preferences: 

• 59% preferred collecting samples in clinics or hospitals, 28% preferred to self-collect at home, and 14% at a laboratory. 

A Promising Solution: HPV Self-Collection Testing 

One of the standout findings from the research is the high level of interest in HPV self-collection testing. This innovative approach empowers women to take control of their health by collecting samples in the privacy of their homes or at a convenient location. The research further revealed that many women are willing to pay up to $36 (approximately R680) for this service if made available at pharmacies.  

Self-collection testing eliminates the need for invasive pelvic exams in clinical settings which many women find uncomfortable or stigmatising. It reduces the logistical challenges of accessing clinics, particularly for women in rural or underserved areas where healthcare facilities are not readily available. Making self-collection kits available in pharmacies could significantly increase screening rates and achieve early diagnosis. 

The Knowledge Gap Among Healthcare Practitioners 

While self-collection testing presents an exciting opportunity, its success depends on a well-informed and capable healthcare system. Unfortunately, the research revealed a concerning lack of understanding among healthcare practitioners regarding the national cervical cancer management protocols.  

Without proper guidance, healthcare providers may fail to offer appropriate counselling, follow-up, or referrals for women with abnormal screening results.  Addressing this issue requires targeted training and capacity-building initiatives. FIND, in partnership with the National Department of Health (NDOH), trained over 700 health practitioners between September and October 2024, 

The Public Awareness Deficit 

Equally troubling is the lack of available information for the public about cervical cancer, its causes, and prevention methods. Many women remain unaware of the importance of regular screening.  Through its community arm, the African Cervical Health Alliance (ACHA), FIND, NDOH, and private sector partners engaged community health partners to develop, adapt and distribute over 10,000 copies of materials to communities about prevention and treatment of cervical cancer. 

A Vision for the Future 

To reduce the burden of cervical cancer in South Africa, we need a multi-pronged approach that combines education, innovation, and systemic reform. This includes: 

1. Policy Support: Advocating for policy changes to integrate self-collection testing into the national screening program and subsidize costs for low-income populations. 
2. Expanding Access to Self-Collection Testing: Making HPV self-collection kits widely available at affordable prices. 
3. Enhancing Practitioner Training: Ensuring healthcare providers are well-versed in national cervical cancer management protocols. 
4. Strengthening Public Awareness Campaigns: Launching nationwide initiatives to educate women and communities about cervical cancer prevention and the availability of new screening options. 

When women have access to convenient, affordable options like HPV DNA self-testing, we’re not just improving health outcomes – we’re giving women control over their health decisions.” Says Dr Ntombi Sigwebela, Regional Director of FIND (https://apo-opa.co/4jMkyJA)

The South African G20 Presidency is prioritizing health equity, solidarity and universal health coverage. Addressing the diagnostics gap for women’s health is crucial to achieving this agenda and building an equitable and inclusive global health architecture.  

For more information on FIND’s Cervical Cancer Elimination Project, visit: FIND South Africa (https://apo-opa.co/4jMkyJA)