Point-of-care HPV testing for cervical cancer screening in Sub-Saharan Africa: platform diversity, diagnostic performance, implementation feasibility, and determinants-a scoping review with contextual considerations for Ethiopia.

backgroundCervical cancer remains a leading cause of cancer-related mortality among women in Sub-Saharan Africa (SSA), where access to laboratory-based screening is limited. Point-of-care (POC) HPV testing enables rapid, near-patient diagnostics that support same-day screen- and treat strategies; however, the evidence base across SSA remains fragmented.

methodsWe conducted a scoping review following the Arksey and O’ Malley and the Joanna Briggs Institute (JBI) framework. Ten electronic databases and grey literature sources (2000–2025) were searched for studies evaluating POC HPV tests in SSA. Data on platform characteristics, diagnostic performance, feasibility, acceptability, barriers, facilitators, and sustainability were extracted and synthesized.

resultsThirty-one unique studies from 15 SSA countries evaluated seven POC HPV platforms (Xpert HPV, careHPV™, AmpFire HPV, LAMP (DARQ), ScreenFire, 8-HPV OncoE6/E7, OncoE6™). Xpert HPV consistently demonstrated high sensitivity for CIN2 + lesions (71–97%) and CIN3 + lesions (68–99%) based on histology-confirmed lesions, with moderate specificity (59–71%) when using biopsy-confirmed histopathology as the reference standard. OncoE6™ exhibited high specificity (98–99%) but lower sensitivity (31–57%). CareHPV performance varied widely (sensitivity 54–97%, specificity 54–94%) and, as with other POC HPV platforms, was influenced by HIV status, sample type, and clinical setting. Acceptability among women was high, especially for self-sampling and rapid results; provider acceptability was supported by minimal training requirement. Evidences from implementation studies suggest that POC HPV testing is operationally feasible in SSA, though key barriers include test costs, supply chain interruptions, and challenges in patient follow-up. Facilitators for feasibility and scale-up include integration with HIV/TB services, community-based outreach, and streamlined workflows. However, data on large-scale implementation, cost-effectiveness, and sustainability remain limited.

conclusionPOC HPV testing in SSA demonstrates adequate diagnostic performance and high acceptability, and feasibility under programmatic conditions. In settings with healthcare infrastructure similar to that of Ethiopia, successful scale-up of POC HPV testing will require integration with the existing health services, strengthened quality assurance, providers training, and robust patient follow-up mechanisms. Future research should focus on implementation trials, cost-effectiveness, effective triage strategies, and long-term sustainability.