Number of women living with HIV who were screened for cervical cancer using any screening test

Export Indicator

The number of women living with HIV who were screened for cervical cancer in the last 12 months using any screening test
What it measures

Progress towards scaling up population-based screening for the prevention of cervical cancer among women living with HIV

Rationale

The purpose of this indicator is to assess the availability and uptake of screening to prevent cervical cancer among women living with HIV. To prevent invasive cervical cancer, women can be screened using various tests to identify those who have or are at risk of cervical precancer. Low cost and appropriate technology screening methods are available that make most precancerous lesions identifiable at stages when they can easily be treated and cured. Achieving high coverage of screening of women - with treatment of precancerous lesions detected by screening - can lead to a low incidence of invasive cervical cancer.

The traditional method to screen women for cervical cancer has been cytology (the Papanicolaou test, also known as the Pap or smear test). Newer screening tests include visual inspection with acetic acid (VIA) and molecular tests, mainly high-risk HPV DNA-based tests, which are suitable for use in all settings. Other molecular tests - as well as more advanced visual inspection tests based on artificial intelligence/machine learning platforms - have also been developed. Cervical cancer screening can be done using different primary screening and triage tests, and there are numerous combinations or algorithms in use in different settings.

Numerator

Number of women living with HIV who had a screening test for cervical cancer using any screening test

Denominator

N/A

Calculation

N/A

Method of measurement

The number is generated by counting the number of women living with HIV among all women who were screened for cervical cancer in the last 12 months, using cervical cancer programme screening and/or HIV programme data as the source.

Each individual should only be counted once within the reporting period. If a second triage test or a follow-up test was performed as part of the screening strategy, that individual should only be counted once.

Measurement frequency

Annual

Disaggregation
  • Age (15-29, 20-24, 25-29, 30–49, 50+ years).
  • People who were screened for the first time in their lives.
  • Cities and other administrative areas of epidemiologic importance.
Additional information requested

Please provide city-specific and other subnational data for this indicator. Space has been created in the data entry sheet to provide information for the capital city and one or two other key administrative areas of high epidemiological relevance, such as those with the highest HIV burden or cities that have committed to ending AIDS by 2030.

Strengths and weaknesses

Since the screening interval between tests depends on the test used, the number of women screened may vary from year to year.

Coverage levels of screening for all women living with HIV is not possible without an estimate of the population size.

Changes in this indicator as measure of progress over time should be interpreted in light of related data, including the number of women known to be living with HIV.

Further information
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71:209-249.
 
Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: World Health Organization; 2020 (https://www.who.int/publications/i/item/9789240014107).
 
Guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. Geneva: World Health Organization; 2021
 
Comprehensive cervical cancer control: a guide to essential practice. 2nd ed. Geneva: World Health Organization; 2014 (https://apps.who.int/iris/bitstream/handle/10665/144785/9789241548953_eng.pdf).
 
Introducing and scaling up testing for human papillomavirus as part of a comprehensive programme for prevention and control of cervical cancer. A step-by-step guide. Geneva: World Health Organization; 2020 (https://www.who.int/publications/i/item/9789240015166).
 
WHO technical guidance and specifications of medical devices for screening and treatment of precancerous lesions in the prevention of cervical cancer. Geneva: World Health Organization; 2020 (http://www.who.int/publications/i/item/9789240002630).
 
Related Indicators
 
ST.3 Cervical cancer screening among women living with HIV, 2020, WHO Consolidated HIV strategic information guidelines: driving impact through programme monitoring and management (https://www.who.int/publications/i/item/consolidated-hiv-strategic-information-guidelines).
 
CXCA_SCRN, PEPFAR, MER 2.0 (Version 2.4), September 2019, Monitoring, Evaluation, and Reporting (https://www.state.gov/wp-content/uploads/2019/10/PEPFAR-MER-Indicator-Reference-Guide-Version-2.4-FY20.pdf).