Table 6.

Innovative technologies and approaches that may be appropriate for comprehensive prevention packages.

Priorities	Recommended intervention	Rationale
PRIMARY PREVENTION
Increase access to and coverage of HPV vaccination by the sustainable implementation of HPV immunization programs	Reduce vaccination dosage	Evidence that a single-dose is as protective as a multi-dose regimen is emerging (173, 207, 208). A single-dose regimen can be as cost-effective as the two-dose regimen, if high coverage can be achieved in low-resource settings (209, 210).
SECONDARY PREVENTION
Maximize early detection of precancers and micro-invasive disease without the harms of overtreatment by increasing cervical cancer screening coverage with HPV testing and treatment starting at age 30 for at least 35 years for women without HIV	HPV testing, focusing on self-sampling	HPV DNA testing has superior sensitivity compared to cytology and VIA in detecting CIN2-3 (99, 209, 211). Self-sampling can overcome individual and structural level barriers to traditional screening methods (212, 213). It has demonstrated similar accuracy as clinician-collected samples (109, 119), and is accepted across cultures and resource-settings (214).
	Triage HPV positive women with enhanced visual assessment or a low-cost test for oncogenesis markers	The triage methods used in high-resource settings, such as cytology, colposcopy, and HPV genotyping are not ideal for low-resource settings because of their need for multiple visits, equipment, and personnel (12, 118). Innovations, such as a portable colposcope, enhanced visual assessment that utilizes mHealth and artificial intelligence, and low-cost rapid biomarker tests can accurately stratify women by the risk of progression to invasive cancer and make the process more efficient (145).
	Treat eligible precancerous lesions with thermal ablation	Thermal ablation has shown comparable efficacy to cryotherapy in treating ablation-eligible CIN2-3 in a shorter amount of time (125), and is easier to implement in LMICs than cryotherapy because it does not need CO2 (128) and devices are battery-operated and portable.