Rwanda Biomedical Center (RBC) in collaboration with BGI (a China-based firm that provides genetic testing and sequencing services) launched a cervical cancer screening pilot project in Ngoma District on April 30. The programme includes self-sampling and Next-Generation Sequencing (NGS) based screening for Human Papillomavirus (HPV) infection, intended to help Rwanda explore a screening model which can effectively procure high coverage of cervical cancer screening for the population. Cervical cancer is the leading cause of female cancer-related death in Rwanda with 1,229 newly diagnosed cases and 829 associated deaths in 2020, and around 3.7 million women aged between 15-59 years at risk of developing cervical cancer, according to RBC. Over the past ten years, Rwanda has attained effective cervical cancer prevention and control interventions, including universal HPV vaccination and the introduction of cervical cancer screening and treatment programmes. The country has also become a model country for effective cervical cancer prevention and control in sub-Saharan Africa and other developing countries in the world. Although the HPV vaccination rate in Rwanda has reached an encouraging level, with more than 90 per cent of girls aged 12 years old completing the HPV vaccination at the end of 2023, women over the age of 25 who have not been vaccinated against HPV are still at risk of HPV infection and cervical cancer. The cervical cancer screening pilot project intends to provide HPV/DNA screening to 20,000 eligible Rwandan women (between 25 and 49 years old living with HIV, and between 30 and 49 years old for the general population) using self-sampling techniques, said Dr Albert Tuyishime, the Head of Diseases Prevention and Control Department at RBC. He stressed that the programme will establish a rapid population-based cervical cancer screening model based on self-sampling technology. “Additionally, the programme will build the capacity of primary healthcare facilities in cervical cancer screening and management of precancerous lesions and prepare the capacity of NGS total solution in cervical cancer screening, and explore other widely used clinical testing applications in Rwanda.” Nathalie Niyonagira, the Mayor of Ngoma District, announced that free testing for breast and cervical cancer began at all healthcare centres on April 15. She emphasized that individuals aged 30 to 65 will receive treatment at health centres and hospitals. “We have already completed testing for cervical cancer in 8,261 girls and women, among these that showed mild symptoms are 110, and 92 were treated, 18 of them are being followed up. There has been a completion of breast cancer screening of up to 648,000 and among those who were found with a breast problem were 292, and still among these, 98 have serious cases in which 18 undertook a biopsy and await the results,” she said. Niyonagira noted that some of the challenges the health sector faces are lack of adequate staff, insufficient medical supplies, and infrastructure. “Regardless of the challenges, we are grateful to the Ministry of Health, RBC, and partners for their dedication to improve the healthcare of our citizens to prevent diseases and provide healthcare. In the same way, I extend my appreciation to all medical staff who have continued to render qualified service to all that need them even though they are still few,” she said. Pudence Rubingisa, Governor of Eastern Province, commended the government of Rwanda, particularly the Ministry of Health and RBC that have elevated the standards of health services, but mostly, with emphasis on to fight against breast and cervical cancers. “I thank the Government of the People’s Republic of China who joined efforts with our government in this fight, to provide treatment, training, and logistics,” Rubingisa said. He highlighted the continuous commitment of both governments stretching from the times of the pandemic when they made it a priority to provide vaccines and other health services. Rubingisa further added: “One of the reasons we are here is to continue to assert that this is possible to prevent and treat cancer if we start the battle early, with everyone understanding what is required of them and raising awareness on the issue to the citizens to understand that there is treatment of breast cancer and vaccination against cervical cancer for girls.” He explained that the research is a campaign that will directly engage the natives and the outcomes will assist in devising better ways to combat some of the challenges. In his speech, Wang Xuekun, the Chinese ambassador to Rwanda, appreciated the cooperation between the two countries and believes that it will boost the health industry of Rwanda and promote China-Rwanda friendship. He explained that BGI donates medical equipment and supplies worth US$1.6 million to improve women's health in Rwanda. “China and Rwanda have conducted fruitful cooperation in the health industry. Among others, China helped to build Kibungo Hospital and Masaka Hospital, which cover a population of 500,000. In 2022, China offered to expand the Masaka Hospital. Upon completion, the hospital will turn into a modern teaching hospital, the largest multi-function hospital in Rwanda. It will also serve as a medical hub of the region beyond Rwanda,” he said. Xuekun noted that since 1982, China has sent 24 batches of medical teams to Rwanda, with a total of 303 doctors. Up to now, they have treated over 700,000 patients, and conducted over 38,000 surgeries. More than 16,300 lives were saved. With its professionalism, the latest 24th medical team is well recognised by its peers in Kibungo Hospital and Masaka. “Our friendship blossoms and bears fruits in areas ranging from high-level exchanges, trade and investment, infrastructure, education to people-to-people exchange. We are now making joint efforts to bring our relations to a higher level.” The screening and sampling work will be carried out by healthcare providers from health centres in Ngoma District and Kibungo Hospital with support from national trainers and mentors in this programme, and RBC will coordinate. The basic work content includes registering the personal information of the screening subjects, issuing samplers, instructing sampling, retrieving samples, and binding samples and personal information. BGI will provide technical support for the work team and two strategies will be used for sample collection, such as facility-based sampling where women will be invited to go to health centres for sampling guided by trained healthcare providers. For extremely remotely located or difficult-to-access health centres, screening will be done in secondary sites including health posts. Only HPV-positive women are asked to go back to the health facility for further follow-up. HPV-negative women will receive automated SMS results. All samples will be sent to the national reference laboratory for testing, within seven days after the sample arrives at the RBC laboratory.
