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Background Screening and treatment of precancerous lesions are not accessible to the majority of women in low-resource settings. Recently, the human papilloma virus (HPV) test has become affordable with its higher accuracy and more objective endpoint as a screening method; however, its implementation has been observed in a few resource-limited countries. This paper aims to describe the process of the pilot implementation of HPV test-based cervical cancer screening and treatment in Cambodia by Cambodian and Japanese societies of gynecology and to identify factors contributing to optimal outcomes. Methods A mixed-methods approach was used. Data from the survey results, the review of peer-reviewed and gray literature, and focus group discussions were analyzed. Results Implementation was performed in three phases: phase A to raise awareness of women’s health and access to cervical cancer screening among factory workers; phase B to improve gynecologic capacity for the diagnosis and treatment of precancerous lesions; and phase C to strengthen the capacity for pathological diagnosis. In phase A, among 687 eligible women, HPV test-based mobile screening was implemented for 132 women with 15 HPV positives. In phase B, gynecologists at three national hospitals became capable of colposcopy and loop electrosurgical excision procedures using standardized protocols. In phase C, the quality of technical skills and communication with clinical services improved for pathologists and technicians. Partnership between two professional societies, strong ownership and commitment of Cambodian society, and a comprehensive and stepwise quality-focused approach are identified to have contributed to the optimal outcomes and as key factors in sustainability. Conclusion Our analysis shows that HPV test-based screening has a potential to be scaled up with self-sustainability in Cambodia. This may serve as a good example of how professional societies can contribute to capacity building and system development for the prevention and control of cancer in a low-income country. |
