HPV Testing Fights Cervical Cancer

Kamfwa says early detection will not only help to save lives but also improve women’s health

By Francis Maingaila

Lusaka, Zambia24 – July 10, 2025

Zambia has recorded a 21 percent positivity rate for Human Papillomavirus (HPV) in a multi-country community-based self-sampling study aimed at scaling up cervical cancer prevention among women, health authorities have revealed.

Dr. Paul Kamfwa, National Cancer Coordinator at the Ministry of Health, provided a comprehensive overview of cervical cancer in the country, disclosing that cervical cancer is currently the leading cause of cancer deaths among women in Zambia.

 The country diagnoses nine women and loses six women daily to this preventable disease. 

He emphasized that cervical cancer can be cured if diagnosed early and appropriate measures are instituted. He also stated that with proper intervention, cervical cancer can ultimately be eliminated.

Speaking during the dissemination of the findings from the Human Papillomavirus (HPV) Community-Based Self-Sampling (CBSS) study, which was conducted in five countries — Rwanda, Malawi, Zimbabwe, Nigeria, and Zambia — Dr. Kamfwa said Zambia enrolled 2,140 women in the research, of which 2,139 were found eligible — a 99.9 percent eligibility rate — showing strong participation and feasibility of the intervention.

He further disclosed that 5.75 million women are at risk of developing cervical cancer, noting that many women, especially in rural areas, lack access to screening services. 

He said the Ministry of Health, with support from partners, has been working hard to scale up cervical cancer screening and treatment and is developing strategies to increase screening and treatment services.

These include integrating cervical cancer screening into sexual and reproductive health and HIV care.

The study was conducted across the five countries under three models: health facility-based, health post-based, and a door-to-door approach piloted in Zimbabwe and Rwanda.

Dr. Kamfwa disclosed that the overall average HPV positivity across all five countries was 21 percent. 

However, Zambia's data revealed notable variation between service delivery models.

“At the health post level in Zambia, HPV positivity was 21 percent, consistent with the multi-country average. 

However, at health facilities, the positivity rate rose sharply to 35 percent, largely attributed to the higher proportion of HIV-positive women accessing care at those centers,” he explained.

He added that while health facilities were more efficient in providing immediate triage and treatment services, health posts proved more accessible, particularly for HIV-negative women, who represent the majority but are often under-screened for cervical cancer.

“In Zambia, HIV-negative women preferred accessing services from health posts due to proximity and convenience, while HIV-positive women, who routinely receive care at health facilities, had higher screening rates and HPV positivity,” Dr. Kamfwa noted.

The study also found that more women received and acted on their test results from health facilities compared to health posts. However, triage — the process of evaluating and linking HPV-positive women to care — was more successful at health posts when multiple follow-up attempts were made.

“On average, one follow-up attempt was sufficient to bring back women for triage, but for those who did not return initially, up to five follow-ups were required,” Dr. Kamfwa said.

“Challenges such as power outages affected sample testing, leading to refusals among some participants to provide repeat samples.”

He further revealed that most of the treatments, including thermal ablation for early cervical lesions, were done at health facilities.

HIV-positive, HPV-positive women who triaged VIA-negative were still treated for precancer in some settings — guidelines and implementation must be uniform across all settings.

The door-to-door model, which was only implemented in Zimbabwe and Rwanda, yielded mixed results, with Rwanda achieving a 93 percent triage rate while Zimbabwe recorded only 63 percent. Due to this variation, the model was considered inconclusive.

Despite these differences, Dr. Kamfwa emphasized that community-based self-sampling is both feasible and acceptable. 

Community Health Workers who participated in the study cited improved privacy, reduced transportation burdens, and shorter waiting times at health posts as key benefits that encouraged women to participate.

“The study confirms that early detection and treatment of HPV can prevent cervical cancer if services are accessible and well-coordinated,” he said.

He recommended the national scale-up of HPV self-sampling through community-based models, including health posts and potentially the door-to-door approach, to expand cervical cancer screening coverage, particularly among the underserved HIV-negative population.

Speaking at the same event, Clinton Health Access Initiative Program Manager in charge of cancer, Memory Samboko, said Zambia has made substantial progress in advancing cervical cancer screening and treatment in the last two decades. 

However, she noted that despite this progress, barriers remain in place that threaten to prevent the country from reaching the targets laid out in the elimination strategy.

The study’s findings will inform Zambia’s cervical cancer screening policy, which aims to reduce the disease burden among women through early diagnosis and timely treatment.