Closing the Cervical Cancer Gap: Integrating HPV Genotyping, Cervical Dysplasia Screening, Vaccination, and Community Awareness in Eastern Kenya

In 2023, cervical cancer was the fourth most common type of cancer among women, with over 600,000 new cases and 340,000 deaths globally. Approximately 90% of the mortality cases occur in low and middle-income (LMIC) countries, especially in Sub-Saharan Africa. It is the leading cause of cancer-related mortality among women in Kenya. Cervical cancer is caused by human papillomavirus (HPV) infection. There are over 200 HPV genotypes, which are classified as high- and low-risk HPVs. This chapter explores how integrating HPV genotyping, cervical dysplasia detection, screening, vaccination, and community awareness can help close the cervical cancer gap in Eastern Kenya. In this study, 317 women – 161 HIV-infected (161) and 156 non-infected—aged 18–46 years (mean age: 34.3, SD ± 10.4) were recruited from Eastern Kenya. HIV-positive women had higher rates of both high- and low-risk HPV type infections, with HPV81, a non-vaccine type, being linked to cervical dysplasia. A higher primary diagnostic accuracy was established by human papillomavirus (HPV) DNA polymerase chain reaction (PCR). HIV-infected women also showed increased specificity through both primary and triage testing approaches. The literature review highlights distinct region-specific challenges and the disproportionate burden of non-vaccine HPV types in other regions. This study reviews how low awareness, poor screening uptake, and persistent misconceptions contribute to late cervical dysplasia diagnosis and poor screening outcomes. This study highlights the need for Eastern Kenya-specific vaccination, culturally sensitive awareness, and molecular diagnostics to accelerate cervical cancer elimination.