Research Project 2

宫颈癌是低收入和中等收入国家妇女癌症相关死亡的主要原因 中低收入国家是造成全球癌症发病率和死亡率差异的关键因素。世界卫生组织建议 人乳头瘤病毒（HPV）为基础的测试，然后立即治疗，被称为筛查和治疗（SAT）。 虽然全球和国家准则认可了可持续发展评估方法，但该方法尚未得到广泛实施 在研究环境之外。新技术，例如Xpert HPV DNA检测、护理点（POC）检测 其与竞争性测定相比具有明显的优势，并且已被证明在低资源条件下具有成本效益。 设置，也更贵。与许多国家一样，南非正在努力解决如何实施和 促进广泛和公平地采用基于HPV的筛查。通过30年的合作， 在哥伦比亚大学和开普敦大学的研究人员之间， 制定和评价Xpert HPV POC-SAT的实施和评价策略， Empilisweni妇女健康中心的项目2将解决POC-SAT的费用和筹资问题， 有针对性的实施战略。在目标1中，我们将使用世卫组织的综合工具估算成本 在公共初级保健环境中实施基于HPV的POC-SAT之前和之后的宫颈癌筛查 在卡耶利沙结果将是每名接受筛查的妇女的成本和每名接受筛查和治疗的妇女的成本。在Aim中 2.我们将进行时间和动作研究，以估计可扩展的、量身定制的实施策略的成本 支持在两个实施项目1目标3的初级保健设施提供POC-SAT的一揽子计划。在Aim中 3.我们将利用财政规划过程来确定、选择和实施创新的HPV融资战略- 基于SAT及其在西开普省的实施。费用数据收集将与下列机构协调进行： 能力建设和利益相关者参与核心，以转化知识需求和研究结果， 如适用我们将通过利用日常的行政和参与活动， 核心利益攸关方会议和外部咨询小组在成本数据前后向利益攸关方介绍情况 收集、分析和报告。这一项目的调查结果将分发给地方和区域一级， 为了帮助有关宫颈癌筛查投资的决策， 在南非广泛使用基于HPV的SAT。

Cervical cancer is the leading cause of cancer-related deaths among women in low and middle-income countries (LMICs) and a key contributor to global disparities in cancer incidence and mortality. The WHO recommends Human Papillomavirus (HPV)-based testing followed by immediate treatment, known as screen-and-treat (SAT). Although endorsed in global and national guidelines, the SAT approach has not yet been widely implemented outside of research settings. New technologies such as the Xpert HPV DNA test, a point-of-care (POC) test which has distinct advantages over competing assays and has been shown to be cost-effective in low-resource settings, is also more expensive. Like many countries, South Africa is grappling with how to operationalize and promote the widespread and equitable uptake of HPV-based screening. Through a 30-year collaboration between investigators at Columbia University and the University of Cape Town, and leveraging Project 1’s development and evaluation of strategies for the implementation and evaluation of Xpert HPV POC-SAT, this Project 2 of the Empilisweni Center for Women’s Health will address the cost and financing of POC-SAT and its tailored implementation strategies. In Aim 1, using a comprehensive tool from the WHO, we will estimate costs of cervical cancer screening pre and post implementation of HPV-based POC-SAT in public primary care settings in Khayelitsha. Outcomes will be cost per woman screened and cost per woman screened and treated. In Aim 2, we will conduct a time-and-motion study to estimate the costs of the scalable, tailored implementation strategy package to support delivery of POC-SAT in two primary care facilities implementing Aim 3 of Project 1. In Aim 3, we will use a fiscal mapping process to identify, select, and pursue innovative financing strategies for HPV- based SAT and its implementation in Western Cape. Cost data collection will be conducted in coordination with the Capacity Building and Stakeholder Engagement Cores to translate knowledge needs and study findings, where applicable. We will further synergize activities by leveraging the routine Administrative and Engagement Core stakeholder meetings and External Advisory Panel to brief stakeholders before and after cost data collection, analysis, and reporting. The findings of this project will be disseminated to local and regional stakeholders in order to aid decision-making regarding investments in cervical cancer screening and advance the widespread use of HPV-based SAT in South Africa.