Cervical cancer is the fourth most common cancer in women worldwide, with up to 85% of the burden in resource restricted countries. Early detection of precancer has shown to be successful in reducing cancer incidence and mortality, however, a global implementation of this approach is hampered by culture and resource differences between countries.
The approach of the CHILI project is three-fold: social science investigations will be conducted to understand current screening practices and to define a tailored strategy, including the ELEVATE tool, embedded in the current health system. Secondly, engineers will validate the self-testing device and will adapt it to reduce the unit price and to enable large-scale manufacturing at an affordable cost. Finally, public health specialists and health economists will evaluate the implementation of the new screening tool to assess its appropriateness and cost-effectiveness.
For the latter objective, an intervention will be implemented: in the first arm, the different steps of current cervical cancer screening practices will be optimized (awareness, pre-and post-counselling and referral). In the second arm, the same strategy will be applied combined with the new point-of-care screening device. Integral part of CHILI is to maximize the use of the new screening tool in low-resource settings in collaboration with national stakeholders and health care providers.
These are the objectives of CHILI:
- To understand current screening practices and to define new strategies that include the ELEVATE self-sampling test and meet the conditions and requirements of the local context to increase screening coverage in the selected low-income countries.
- To adapt and upscale the ELEVATE screening device to be used as a universal screening test in low-income countries.
- Health technology assessment of the adapted ELEVATE screening device, determining its user-acceptability, uptake and cost-effectiveness, by implementing and evaluating the new screening strategies in the selected low-income countries.