Background: Cervical cancer is a significant global public health issue, with an effective screening strategy being a key challenge in its prevention. The primary objective of this study was to determine the prevalence of HPV and assess the contribution of molecular screening to primary cervical cancer detection in Dakar. Patients and Method: This cross-sectional study was conducted from January 2016 to December 2020. We compared cervico-vaginal smear results, classified according to the Bethesda 2014 system, with molecular screening results from the Cobas？ 4800 HPV test (Roche). Additionally, we conducted a survey of health facilities in the Dakar medical region to evaluate the availability and accessibility (cost) of molecular testing. Results: A total of 106 patient files were analyzed. The mean age of the patients was 43.6 years (range: 22 - 76 years). Smears were normal in 41.5% of cases. Detected lesions included ASCUS (49.1%), LSIL (5.7%), and HSIL (3.8%). The overall prevalence of HPV infection was 30.2%, with non-genotype 16/18 high-risk HPV (HR HPV) infections being the most common (73%). Genotypes 16 and 18 were found in 16% and 11% of cases, respectively. Among normal smears, HPV was present in 11.3% of cases. HPV typing was positive in 40.3% of ASCUS smears and 83.3% of LSILs. HPV testing identified 85% of lesions classified as CIN2 or higher, compared to only 70% detected through cytology. The survey revealed that molecular HPV screening was unavailable in referral hospitals, and the high cost of testing in the private sector posed a significant barrier to access. Conclusion: Cervical cancer remains a serious public health issue in Senegal. The proven effectiveness of preventive measures, such as vaccination against the most oncogenic HPV types and molecular screening for HPV detection, could significantly reduce the incidence of this disease.
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