Editors: Paolo Giorgi-Rossi, Maria Lina Tornesello & Franco Maria Buonaguro
Point-of-Care (POC) or Point-of-Care Testing (POCT) have been generally intended for rapid diagnostic testing (<90 minutes) to detect and diagnose infectious diseases quickly, close to the patient-healthcare interface. The COVID-19 pandemic has underlined the potential uses of POCT devices on a large scale to detect infectious diseases and for public health risk management as well as protecting fragile cancer patients. The study and the implementation of POC for HPV-based screening is stretching out to its current maximum potential the concept of rapid diagnosis of chronic infectious disease, with risk of cancer progression, to include clinical validation and treatment, to provide each woman, also in LMICs, with the possibility of effective secondary prevention of cervical cancer. In the last 5 years, the Infectious Agents and Cancer journal hosted some paradigmatic pieces of the scientific debate on HPV screening in sub-Saharan Africa (Mungo 2024, Dreyer 2024; Parhm 2023; Moyo 2023; Desai 2020; Onyango 2020). This collection is willing to highlight the richness of the debate, presenting the results and focusing on the open questions. These start from how to reach the women who mostly can benefit from screening, increasing their awareness, health literacy and, finally, participation in screening, including the opportunity of introducing self-sampling and how to propose it. The main barrier to a massive screening in LMIC is still the cost of the intervention, researchers are working to develop and validate HPV assays that are sustainable and feasible as POCT, possibly clinically validated also on self-sample. The one-step screening needs to rapidly identify women that can deserve treatment possibly avoiding histological assessment. Studies are investigating the best triage strategies to stratify women according to their risk of CIN3+. Accurate triage and risk stratification also open the question of how to manage woman who are HPV-positive and triage-negative; these women finitely do not deserve treatment but have a high risk of CIN3+ in the future. Defining appropriate, feasible, and acceptable follow up strategies for these women is a new research need. The collection of the included studies goes from the laboratory to the community, from the validation of new molecular methods to capacity building of professionals and community involvement.