ASPIRE Mayuge

Uganda has not yet implemented a comprehensive national screening program, which has contributed to high cervical cancer incidence rates across the country (54.8 per 100,000). Cervical cancer screening is offered opportunistically, especially in rural regions, largely as a result of resource constraints. The integration of a self-collected cervical cancer screening program using HPV testing within community-based health systems could reduce individual and health system barriers in Uganda and empower women to take leadership in their own health.

In partnership with the Uganda Cancer Institute, we conducted a 2-armed pragmatic cluster randomized trial in the rural Mayuge district of Uganda. The project aimed to compare the effectiveness of two community-based cervical cancer screening models using self-collected HPV testing:

1) Door-to-door recruitment facilitated by community health workers and 
2) Community health days.

Attendance at follow-up treatment was the primary outcome of interest. Door-to-door recruitment showed slightly higher odds of follow-up for treatment, though both arms showed high rates of screening and treatment uptake. Results from this study will inform the national scale-up of cervical cancer screening in Uganda, aligning with the World Health Organization’s target of achieving cervical cancer elimination through the pillar of increased HPV screening coverage.