Cervical cancer screening in Sub-Saharan Africa: A scoping review of test and treat and test, triage and treat approaches.

OBJECTIVES: To synthesize the evidence on the implementation, coverage and performance of cervical cancer screening programmes using test-treat and test-triage-treat approaches in Sub-Saharan Africa, with a focus on HPV testing, self-sampling and single-visit models. STUDY DESIGN: Scoping review. METHODS: The review of the literature was conducted using PubMed to identify studies reporting on HPV-based screening strategies, single-visit approaches, vaginal self-sampling and ablative treatment (including thermal ablation) within test-treat or test-triage-treat frameworks in Sub-Saharan Africa. Data on screening uptake, acceptability, feasibility and treatment implementation were extracted and synthesised. RESULTS: HPV-based screening is consistently more sensitive and effective compared to cytology or visual inspection; however, coverage still remains low across the region. Single-visit approaches reduce loss to follow-up and address barriers related to cost and transportation, making it the preferred strategy in most low-resource and rural settings. Vaginal self-sampling demonstrates high acceptability and feasibility, facilitating access among hard-to-reach populations. Thermal ablation appears as a feasible and a well-tolerated ablative treatment in screen-and-treat programmes. CONCLUSIONS: There is an urgent need to scale up HPV-based cervical cancer screening in Sub-Saharan Africa. It will require the systematic integration of single-visit models, self-sampling and accessible treatment modalities such as thermal ablation. These approaches are essential to improve coverage, reduce attrition and support sustainable progress towards cervical cancer elimination in low-resource settings.