Evaluating and Scaling a Single-Visit Screen-and-Treat Approach Using Thermal Ablation to Prevent Cervical Cancer in Kenya

What this Trial Is About

Cervical cancer is a major health concern, especially in low- and middle-income countries like Kenya, where it remains the second most common cancer and leading cause of cancer death among women. Despite being largely preventable through early detection and treatment of pre-cancerous lesions, screening and treatment rates are low due to challenges such as equipment shortages and costs. This research aims to evaluate the implementation and cost of introducing thermal ablation, a safer and easier treatment alternative to cryotherapy, in reproductive health clinics in Kenya to improve cervical cancer prevention efforts. The study involves delivering the single visit screen-and-treat approach using thermal ablation SVA-SATTA at 10 reproductive health clinics in central Kenya. Thermal ablation uses local heating to destroy abnormal cervical tissue and can be powered by electricity, batteries, or solar energy. The research employs a stepped-wedge, cluster randomized design over five years to introduce and evaluate this approach using the RE-AIM framework, which assesses reach, effectiveness, adoption, implementation, and maintenance of the intervention. The study also includes cost and budget impact analyses comparing thermal ablation to cryotherapy. Participants include women seeking cervical cancer screening, women who test positive for pre-cancerous lesions, health care providers, and health managers. The study collects data through interviews, training records, treatment completion rates, HPV clearance tests, and clinic adoption measures. Outcomes include barriers and facilitators to implementation, the number of trained providers delivering treatment, sustained use of thermal ablation, and the impact on treatment uptake. Participant involvement spans up to four years with additional monitoring six months post-treatment for HPV clearance.

Cervical Cancer Elimination -Using Implementation Science to Evaluate Deliver and Cost Introduction of Thermal Ablation