scholarly journals Role of HPV testing in the NHS Cervical Screening Programme

2007 ◽  
Vol 12 (5) ◽  
pp. 7-10
Author(s):  
Elizabeth McLellan
Keyword(s):  
Screening Programme ◽  
Cervical Screening ◽  
Hpv Testing

scholarly journals The Clinical Role of HPV Testing in Primary and Secondary Cervical Cancer Screening

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
G. Hoste ◽  
K. Vossaert ◽  
W. A. J. Poppe
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Screening Methods ◽  
Hpv Testing ◽  
Clinical Role ◽  
Screening Programs ◽  
Hpv Test

Traditional population-based cervical screening programs, based on cytology, have successfully reduced the burden of cervical cancer. Nevertheless limitations remain and new screening methods are emerging. Despite vaccination against the 2 most oncogenic types (HPV 16/18), cervical cancer screening will have to continue as an essential public health strategy. As the acquisition of an HR-HPV infection is critical in the progression to (pre-)cancerous cervical lesions, recent research has focused on HR-HPV detection. The sensitivity of HPV testing in primary and secondary prevention outweighs that of cytology, at the cost of slightly lower specificity. Although most of the HR-HPV infections are cleared after conization, new evidence from numerous studies encourages the implementation of HR-HPV testing and genotyping to improve posttreatment surveillance. An HR-HPV test 6 months after conization is a promising useful clinical marker to detect persistence and prevent progression. This review highlights the clinical role of HPV testing in primary and secondary cervical cancer screening.

scholarly journals Randomised trial of HPV self-sampling among non-attenders in the Slovenian cervical screening programme ZORA: comparing three different screening approaches

2018 ◽  
Vol 52 (4) ◽  
pp. 399-412 ◽  
Author(s):  
Urska Ivanus ◽  
Tine Jerman ◽  
Alenka Repse Fokter ◽  
Iztok Takac ◽  
Veronika Kloboves Prevodnik ◽  
...  
Keyword(s):  
Screening Programme ◽  
Cervical Screening ◽  
Randomised Trial ◽  
Intraepithelial Neoplasia ◽  
Response Rates ◽  
Risk Difference ◽  
Control Group ◽  
Hpv Testing ◽  
Opt Out ◽  
Screening Approaches

Abstract Background To overcome obstacles within the Slovenian organised cervical cancer screening programme, a randomised pilot study of human papillomavirus (HPV) self-sampling among non-attenders was performed, aiming to assess three different screening approaches. Participants and methods Non-attenders aged 30–64 years from two Slovenian regions were randomised to two HPV self-sampling groups–the opt-in (I1, n = 14.400) and the opt-out (I2, n = 9.556), with a control group (P, n = 2.600). Self-collected samples were analysed using the Hybrid Capture 2 assay. HPV-positive women were invited to a colposcopy. The overall and type-specific intention-to-screen response rates and histological outcomes with a positive predictive value (PPV) according to the women’s age, the screening approach, the level of protection resulting from previous screening history, and the region of residence were assessed. Results Of the 26.556 women enrolled, 8.972 (33.8%) responded with self-sample for HPV testing and/or traditional cytology within one year of enrolment. Response rates were 37.7%, 34.0% and 18.4% (p < 0.050) for opt-out, opt-in and control groups. Cervical intraepithelial neoplasia (CIN)2+ was diagnosed in 3.9/1.000, 3.4/1.000, and 3.1/1.000 women (p > 0.050), respectively. PPV of the HPV self-sampling was 12.0% and 9.6% for CIN2+ and CIN3+. The highest PPV was obtained in non-attenders in screening programme for more than 10-years and concordant results of HPV testing with 40.8% for CIN2+ and 38.8% for CIN3+. Conclusions The results of our study show that a high response to HPV self-sampling can be achieved also in an opt-in approach, if women are encouraged to choose between self-sampling at home and screening with gynaecologist. In addition, clinically important risk difference for a high-grade cervical lesion exists in the case of a positive result of HPV testing on self-collected samples, depending on the length of the interval since last screening. Stratified management of these women should be strongly considered. Women who were not screened with cytology for at least 10 years should be referred to immediate colposcopy for histology verification instead to delayed re-testing.

scholarly journals Evidence-based cervical screening: experts’ normative views of evidence and the role of the ‘evidence-based brand’

2020 ◽  
Vol 16 (3) ◽  
pp. 359-374 ◽  
Author(s):  
Jane Williams ◽  
Lucie Rychetnik ◽  
Stacy Carter
Keyword(s):  
Screening Programme ◽  
Guideline Development ◽  
Cervical Screening ◽  
Population Level ◽  
The Other ◽  
Screening Tests ◽  
Evidence Based ◽  
Development Processes ◽  
Based Medicine

Background:Organised cervical screening programmes are a combination of arrangements designed to maximise benefit and minimise harm associated with cervical cancer at the population level. Many organised programmes are described as ‘evidence-based’, reflecting an expectation that healthcare should be based on the tenets of Evidence-Based Medicine (EBM). EBM is both normalised and contested. Aims and objectives:As part of a larger study of how cervical screening came to be the way it is, we conducted a grounded theory study of cervical screening experts’ perspectives on evidence and its use in guideline development processes. Methods:We sampled from several countries and across a range of professional backgrounds. Analysis was developed through transcript coding and memo writing, using constant comparison to develop insight and connections between concepts. Findings:We found that the ‘evidence-based’ descriptor was used rhetorically to indicate scientific trustworthiness; in short ‘evidence-based’ indicated ‘good’. Experts held ideal conceptions of evidence and its use as objective and value-free, yet reported experiences that suggested those ideals were unattainable in practice. The ‘evidence-based’ ideal included restricting what counts as evidence to matters of science and epidemiology. This produced pronounced attention to matters of efficacy and effectiveness of cervical screening tests, and neglected decisions relating to the other arrangements that combine to produce an organised screening programme. Discussion and conclusions:Rhetorical use of the ‘evidence-based brand’ appeals to a particular kind of authority: one which is difficult to achieve in practice, and belies the variety of information that is required and the socially negotiated nature of policy and programme decisions.

scholarly journals ‘It has saved thousands of lives, so why change it?’ Content analysis of objections to cervical screening programme changes in Australia

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019171 ◽  
Author(s):  
Helena M Obermair ◽  
Rachael H Dodd ◽  
Carissa Bonner ◽  
Jesse Jansen ◽  
Kirsten McCaffery
Keyword(s):  
Cervical Cancer ◽  
Content Analysis ◽  
Women’S Health ◽  
Women's Health ◽  
Screening Programme ◽  
Cervical Screening ◽  
Pap Smears ◽  
Hpv Testing ◽  
Incidence And Mortality ◽  
Screening Intervals

ObjectivesThe incidence and mortality of cervical cancer have halved since introduction of the Australian cervical screening programme in 1991, involving 2-yearly Pap smears from ages 18–69 years. In 2017, the programme changed to 5- yearly primary human papillomavirus (HPV) testing for women aged 25–74 years. This study investigated reasons for opposition to the renewed screening programme within the open-ended comments of an online petition, ‘Stop May 1st Changes to Pap Smears—Save Women’s Lives’, opposing the changes, which received over 70 000 signatures and almost 20 000 comments.MethodsContent analysis of a random sample of 2000 comments, reflecting 10% of the 19 633 comments posted in February–March 2017.ResultsNineteen codes were identified, reflecting four themes: (1) valuing women’s health and rights, (2) political statements, (3) concerns about healthcare funding cuts and (4) opposition to specific components of the new screening programme. The most prevalent codes were: placing value on women’s health (33%), concerns about increasing screening intervals (17%) and opposition to the changes related to personal experiences with cervical cancer or cervical abnormalities (15%). Concern about the key change in technology (HPV testing instead of Pap smears) was expressed in less than 3% of comments, and some opposition to the changes from health professionals was noted.ConclusionsScreening changes within this selected group were perceived as threatening women’s health, as a political policy created by male decision-makers and as a cost-cutting exercise. Many commenters were concerned about increased screening intervals and later screening onset, but little opposition was expressed regarding the testing technology itself. This analysis may inform public education and communication strategies for future changes to cervical screening programmes internationally, to pre-emptively address specific concerns about the changes.

Sign in / Sign up

Export Citation Format

Share Document