Regular screening of women over 30 years old every three to five years can detect precancerous and cancerous cervical lesions. However, coverage remains low despite the National Programme for Screening including visual inspection with acetic acid (VIA) for breast, oral, and cervical cancers.

Persistent infection with carcinogenic human papillomavirus (cHPV) types is the necessary cause of cervical cancer. The World Health Organization (WHO) recommends transitioning to HPV testing as the optimal strategy for cervical cancer elimination. According to WHO guidelines, two rounds of screening at ages 35 and 45 with validated HPV tests can suffice to achieve elimination.

Most existing HPV tests are costly, require sophisticated technology, and are unavailable at last-mile health facilities. A point-of-care (PoC) testing approach for cHPV detection could provide an affordable diagnostic breakthrough, enabling early detection and same-day treatment of positive cases.

A new multi-centre study published in the International Journal of Cancer highlights the potential scalability of PoC tests as low-cost screening tools in India and other low and middle-income countries (LMICs). The research was conducted across leading institutions, including AIIMS New Delhi; ICMR-National Institute of Cancer Prevention and Research, Noida (NICPR); and ICMR-National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, in collaboration with the WHO-International Agency for Research on Cancer (IARC), France, and supported by DBT-BIRAC Grand Challenges India.

The study aimed to evaluate indigenous HPV DNA testing platforms for primary cervical cancer screening, as previous Indian tests had not been validated according to WHO international standards. Four point-of-care tests were assessed, with two deemed suitable for inclusion in the National Programme.

Dr Neerja Bhatla, Professor Emeritus at NCI and former Head of Obstetrics & Gynaecology at AIIMS New Delhi, lead author and study coordinator, noted, "This study is among the first to apply the WHO Target Product Profile (TPP) and IARC criteria to evaluate reduced-valency HPV assays to tests developed in India." She explained that the initial step was to encourage development of HPV tests targeting the eight most common HPV types contributing to cervical cancer, designed for district and subdistrict-level facilities requiring minimal training.

"This study demonstrates that indigenous platforms can achieve clinical validation, quality standards, and accuracy comparable to global gold-standard tests. It will be a game-changer for cervical cancer prevention and early detection in India," Dr Bhatla added.

Dr Shalini Singh, Director of ICMR-NICPR, emphasised the importance of HPV DNA testing at ages 35 and 45 as central to WHO's cervical cancer elimination strategy. She stated, "Affordable indigenous solutions are essential to expand screening coverage and reduce disease burden," highlighting high costs as a major barrier to wide implementation in LMICs.

Dr Showket Hussain, a corresponding author, remarked that the validated platform has strong potential for nationwide integration, given district-level personnel's familiarity with its use. He also noted that future developments, including self-sampling and high-throughput adaptations, could improve accessibility further.

The findings support India's cervical cancer elimination goals and offer a scalable model for other low-resource settings globally. Although HPV vaccination, recently launched as a National Campaign, will positively impact younger generations, there remains an urgent need to incorporate HPV testing for more effective screening of women over 30 years at risk of cervical cancer.