Feasibility and acceptability of HPV testing using GeneXpert for cervical cancer screening in Morocco

Human papillomavirus (HPV) testing is increasingly recommended for cervical cancer screening. To evaluate the potential large-scale implementation of HPV testing in Morocco, we conducted a pilot study to assess its acceptability and feasibility in four provinces. This study involved 999 women aged 30 or 40 years. Face-to-face interviews were conducted, and HPV testing was performed via the GeneXpert system. Of the 1097 women invited, 91.1% were involved. Most participants (62.9%) were from urban areas, with age groups distributed between 30 s (46.0%) and 40 s (54.0%). The majority of the samples were received without issues affecting HPV testing. The mean time from sample collection to test results was 7.5 ± 6.1 days. On the GeneXpert workstation, 1.1% of the samples yielded invalid results. Among the remaining 972 samples, HPV DNA was detected in 4.8% of the samples, with HPV 16 being the most common type (27.7%). Among the HPV-positive patients, 21.3% refused colposcopy. Among those who underwent colposcopy, abnormal findings (51.4%) included TAG I, TAG II, and suspected invasive cancer. Biopsies revealed normal findings in 47.4%, CIN1 (21.1%), CIN2 (10.5%), CIN3 (15.8%), and carcinoma in situ (5.2%) patients. All patients were managed in accordance with the World Health Organization (WHO) guidelines for comprehensive cervical cancer control (WHO, 2014). HPV testing via the GeneXpert platform may be a reliable and user-friendly tool for the early detection of cervical lesions, with the potential to reduce the incidence and mortality of cervical cancer in Morocco.