Assessing the feasibility of HPV screening for cervical cancer in pregnant women in Ethiopia

Pregnant women have historically and are currently being excluded from cervical cancer screening in most low and middle-income countries (LMICs). The aim of this study was to assess the feasibility and outcomes of including pregnant women in a HPV self-sampling-based screening program in Ethiopia. Pregnant women, recruited from a previously established cohort, were included. They answered a questionnaire and provided HPV self-samples. If the woman was HR-HPV positive, she underwent triage with VIA with or without Iodine. If positive in triage, the woman was re-scheduled after delivery for a new exam. Primary outcome was screening participation. The participation rate of pregnant women was 92.1% (117/127) (95% CI 86.0–96.1%). They had the same knowledge about cervical cancer and acceptance rate to the study as their non-pregnant peers. Pregnant women had less history of previous screening (p = 0.08). The HPV prevalence was 25.4% (29/114) in self-samples. 93.1% (27/29) attended follow-up, where only 11 had not delivered, and 54.6% (6/11) had detectable HPV infection in their cervical samples. Including pregnant women in HPV self-sampling-based screening is feasible and highly accepted. The findings support integrating pregnant women into cervical cancer screening programs in to enhance prevention and early detection efforts. Clinical trials ID: NCT05125380.