Outcomes of a National HPV-DNA based Cervical Screening Pilot: Results from aCollaborative Model in Dolakha and Dhulikhel Hospital, Nepal

Abstract

Background: Cervical cancer is the most common Gynaecological malignancy in Nepal. The screening coverage remains only around 8% despite national targets of 70%. HPV DNA testing offers a sensitive method suitable for low-resource settings. In 2022–2023, Nepal launched HPV-based pilot screenings in seven districts, including Dolakha district. Objectives: To describe the management of HPV positive women identified in the National cervical cancer screening program through collaborative approach. Methods : A retrospective cross-sectional study was conducted using secondary data from the government-led National HPV DNA cervical cancer screening program implemented in Bhimeshwor Municipality, Dolakha in collaboration with Dhulikhel Hospital. Data from 2,235 women aged 30 years and above with complete screening records were analyzed. Variables included age, ward, HPV and Visual Inspection with Acetic acid results, biopsy findings, treatment received, and follow-up status. Microsoft Excel (Version 2508) was used to summarize the data. Results :Out of 9,640 eligible women, 2,235 were screened, achieving a 23.18% coverage. A total of 210 women (9.4%) tested positive for HPV DNA. Among HPV-positive cases, 210 (99%) received follow-up care and among them 100% Visual Inspection with Acetic acid positive cases received appropriate treatment based on tissue biopsy report.   Conclusion :Despite limited resources, the collaborative approach helped the program achieve full follow-up and treatment for HPV-positive women. This study highlights the need for collaboration of local stakeholders at planning level to improve the screening coverage.