Background: NCI scientists are helping to establish cervical cancer screening in high-risk, low-resource regions using HPV-based screen and treat strategies. One major effort in cooperation with Nigerian collaborators and Qiagen is to launch careHPV in a public health setting.

Objectives: To introduce careHPV testing in Nigeria and evaluate the practicality and performance of the test.

Methods: Using stratified random sampling, we consented and enrolled ~1500 women aged 15+, in a large rural Nigerian village. Non-virgins had a cervical exam including VIA, liquid-based cytology prepared and read in the U.S., and PCR-based HPV testing.  Approximately 400 women with any positive screening result and 100 random screen-negative controls were referred to colposcopy. At this visit, a specimen was taken for careHPV. Qiagen trained an NCI scientist without laboratory background, who trained the local technician who, in turn, trained a second technician. Both technicians had secondary school training and no laboratory experience. Residual specimens were tested for the presence of any carcinogenic HPV using PCR.

Results: At this time, results are available for 93 of the women seen at colposcopy. After initial logistical problems, technician 1 evaluated 36 specimens (5 twice) and technician 2 evaluated 91 specimens (51 twice). Overall agreement between technician 1 and 2 was 30/34 (88.2%) with discordance likely due to labeling error. Intra-rater agreement was 55/56 (98.8%) with one error likely due to well contamination. We will present all comparisons at the meeting.

Conclusions: CareHPV testing is practical and reasonably reproducible in rural Nigeria, outside of laboratory settings. Data regarding its accuracy and utility as the basis for screen and treat prevention strategies are imminent.