Nasiha Soofie is the Country Medical and Scientific Affairs Lead for South Africa & neighbouring SADC countries at Roche Diagnostics. Her role is to create disease awareness among healthcare professionals and patients. Here, she discusses the value of diagnostics in fighting HPV (Human Papillomavirus) in Africa. 

The preventable threat

“HPV is a serious threat to African women’s’ health. Although most HPV infections clear up on their own, there is a marked risk for all women that HPV infection may progress to invasive cervical cancer, as HPV is the primary cause of the disease.

The most important thing to note, however, is that cervical cancer is a preventable and curable disease, provided it is detected early and managed effectively. Yet it remains the fourth most common form of cancer among women worldwide.¹⁹ This astounding number points to the immense value of diagnostics in the current African context.

“In 2018, cervical cancer claimed the lives of more than 300 000 women. Tragically, nearly 90% of all deaths worldwide occurred in low-and middle-income countries, pressing the point that women’s health could be considered a human rights issue. Even in developed countries, many cancer cases are diagnosed at an advanced stage, when they are harder to treat successfully.  And the inability to provide treatment condemns many people to unnecessary suffering and early death. ¹⁹

Early diagnosis, early intervention

“Early diagnosis of cancer can result in prompt treatment. Cervical cancer is a slow spreading cancer and can take 15-20 years to develop in women with normal immune systems. However, those with weakened immune systems, like those infected with HIV, can develop cervical cancer in as little as five years. ^17.

Adequate – and early – diagnostics simplify patient screening, triage, and diagnosis, allowing healthcare professionals to find disease earlier, provide clearer answers more quickly and increase the certainty of results. Advanced cervical cancer tests detect the strongest indicators of disease in all women, of every age.

When the emphasis is on efficiency, accuracy and objectivity, it minimises the need for unnecessary and invasive procedures that take up valuable time and resources. It is important that women are empowered with the right information at the right time for optimal health management.

The role of diagnostics in aiding healthcare providers

“Accurate diagnostic tools equip healthcare providers to rapidly and accurately screen women, provide clear answers to their patients and triage results immediately. Singular focus on the science behind cervical cancer helps develop technology proven to identify women at risk of cervical cancer earlier and give doctors and technologists precise information.²³

“The World Health Organisation recommends screening for women aged 30 to 49 years by way of regular Pap smears. The Pap test, which has been standard for more than 60 years revolutionised cervical cancer prevention. However, cancer rates are no longer declining and a more thorough way of detecting the disease is vital. This is where the advancements in diagnostics step in. Modern technology, using HPV DNA testing identifies the cause of >99% of cervical cancer.²⁴   

As the role of the human papillomavirus virus in contributing to the cancer has emerged in recent years, screening for HPV has started to rival the Pap.²¹ Cervical cancer rarely causes overt symptoms in its early stages — when treatment is most effective — so, screening for the different types of HPV infection at the greatest risk of progressing to cervical pre-cancer and cancer is imperative. ²²

The value of diagnostics 

“Diagnostics lie at the core of any prognosis but remain one of the biggest challenges faced in healthcare today. The more advanced and reliable diagnostic solutions are, the earlier clinicians can make accurate decisions with confidence, leading to better decision making.

While the patient can only benefit from this, greater society benefits too. Advanced diagnostics lead to better use of resources and less pressure on the healthcare system. A healthcare system that is using its funds efficiently, ultimately achieves greater access and better outcomes. ²⁵

“The COVID-19 pandemic raised much-needed awareness around of the role diagnostics and the part they play in disease prevention and management. In fact, awareness grew so much that 2020 became a launch point for what is being referred to as ‘the decade of diagnostics.’ The World Health Organization has stated that, ‘diagnostic testing has become indispensable for diagnosing and monitoring disease, for providing prognoses and for predicting treatment response’.³

“Prompt and accurate diagnosis ensures the best possible care, in time to potentially prevent or slow disease progression and save lives. Quicker and more accurate also means it is more accessible, which translates to better results across the entire healthcare ecosystem”.²⁶

(References) 

1. Verlohren, S., et al. (2012). Am J Obstet Gynecol 206(1), e1-8
2. Verlohren, S., et al. (2010). Am J Obstet Gynecol 202(161), e1-11
3. Verlohren, S., et al. (2014). Hypertension 63(2), 346-352
4. Hund, M., et al. (2014). BMC Pregnancy and Childbirth 14, 324
5. Zeisler, H., et al. (2016). N Engl J Med 374(1), 13-22
6. Hund, M., et al. (2015). Hypertens Pregnancy 34(1), 102-115
7. Klein, E., et al. (2014). PLoS ONE 11(5), e0156013
8. European Society of Human Reproduction and Embryology. https://www.eshre.eu/Press-Room/Resources.aspx (Last accessed March 2018)

References sourced from:

1. https://www.roche.com/research_and_development/what_we_are_working_on/womens-health.htm
2. https://diagnostics.roche.com/global/en/products/params/elecsys-sflt-1-plgf-preeclampsia.html 
3. https://www.afro.who.int/health-topics/maternal-health (last accessed July 2021)
4. https://data.unicef.org/topic/gender/maternal-health-gender/ (last access July 2021)
5. https://sdgcafrica.org/wp-content/uploads/2017/03/sdgca-africa-2030-report.pdf
6. https://www.un.org/africarenewal/magazine/december-2016-march-2017/dying-lack-medicines
7. https://pubmed.ncbi.nlm.nih.gov/17099328/
8. https://globalhealthprogress.org/collaboration/strengthening-diagnostics-capabilities-in-africa/
9. https://www.afro.who.int/health-topics/cervical-cancer
10. https://pubmed.ncbi.nlm.nih.gov/30848083/
11. https://www.who.int/news/item/03-02-2017-early-cancer-diagnosis-saves-lives-cuts-treatment-costs
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365441/
13. https://time.com/3025178/hpv-test-vs-the-pap-smear-which-detects-cancer-better/
14. https://diagnostics.roche.com/global/en/products/params/cobas-hpv.html
15. https://www.cervicalcancer-screening.com/
16. https://diagnostics.roche.com/global/en/products/params/cobas-hpv.html
17. https://www.roche.com/about/business/diagnostics.htm
18. https://www.roche.com/about/business/diagnostics/value-of-diagnostics.htm

By Nasiha Soofie

Country Medical and Scientific Affairs Lead for South Africa & neighbouring SADC countries at Roche Diagnostics