What Has Changed Since the Introduction of Human Papillomavirus Testing with the Cytology-Based Cervical Cancer Screening System in Japan A Social Experiment

2019 ◽  
Vol 63 (5) ◽  
pp. 385-390 ◽  
Author(s):  
Mariko Hashiguchi ◽  
Yoshifumi Nakao ◽  
Atsuko Honda ◽  
Atsushi Kawaguchi ◽  
Katsuyuki Hanashima ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
City Government ◽  
Hpv Testing ◽  
Screening System ◽  
Social Experiment ◽  
Screening Programs ◽  
Incidence And Mortality

Background: Uterine cervical cancer is the fourth most common female cancer in the world. In Japan, we have an apparently low rate of joining cervical cancer screening programs compared with Western countries. Furthermore, the incidence and mortality rate of cervical cancer among the younger generation has been increasing. Object: The aim of this study was to assess the effectiveness of cervical cancer screening with human papillomavirus (HPV) testing and cytology in Japan. Methods: Collaborating with Saga City government, we initiated a cervical cancer screening system consisting of HPV testing and baseline cervical cytology from April 2011 as a social experiment. A total of 17,284 participants have been screened with this new combination system. Results: After HPV testing with cytology-based cervical cancer screening, the number of screenings done in women aged under 40 years has significantly increased. In addition, the number of women diagnosed with cervical intraepithelial neoplasia grade 3 has increased (25 of 14,025 vs. 146 of 23,049 under 50 years: p < 0.001). Conclusion: These data suggested that the introduction of HPV testing with cytology-based cervical cancer screening as an adjunct to conventional cytology resulted in better efficiency and more accurate screening among the Japanese population.

scholarly journals Impact of human papillomavirus (HPV) self-collection on subsequent cervical cancer screening completion among under-screened US women: MyBodyMyTest-3 protocol for a randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Lisa P. Spees ◽  
Andrea C. Des Marais ◽  
Stephanie B. Wheeler ◽  
Michael G. Hudgens ◽  
Sarah Doughty ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cancer Incidence ◽  
Perceived Risk ◽  
Pap Test ◽  
Hpv Testing ◽  
Cervical Cancer Incidence ◽  
Incidence And Mortality

Abstract Background Screening substantially reduces cervical cancer incidence and mortality. More than half of invasive cervical cancers are attributable to infrequent screening or not screening at all. The current study, My Body My Test (MBMT), evaluates the impact of mailed kits for self-collection of samples for human papillomavirus (HPV) testing on completion of cervical cancer screening in low-income, North Carolina women overdue for cervical cancer screening. Methods/design The study will enroll at least 510 US women aged 25–64 years who report no Pap test in the last 4 years and no HPV test in the last 6 years. We will randomize participants to an intervention or control arm. The intervention arm will receive kits to self-collect a sample at home and mail it for HPV testing. In both the intervention and control arms, participants will receive assistance in scheduling an appointment for screening in clinic. Study staff will deliver HPV self-collection results by phone and assist in scheduling participants for screening in clinic. The primary outcome is completion of cervical cancer screening. Specifically, completion of screening will be defined as screening in clinic or receipt of negative HPV self-collection results. Women with HPV-negative self-collection results will be considered screening-complete. All other participants will be considered screening-complete if they obtain co-testing or Pap test screening at a study-affiliated institution or other clinic. We will assess whether the self-collection intervention influences participants’ perceived risk of cervical cancer and whether perceived risk mediates the relationship between HPV self-collection results and subsequent screening in clinic. We also will estimate the incremental cost per woman screened of offering at-home HPV self-collection kits with scheduling assistance as compared to offering scheduling assistance alone. Discussion If mailed self-collection of samples for HPV testing is an effective strategy for increasing cervical cancer screening among women overdue for screening, this method has the potential to reduce cervical cancer incidence and mortality in medically underserved women at higher risk of developing cervical cancer. Trial registration ClinicalTrials.gov NCT02651883, Registered on 11 January 2016.

scholarly journals Community level barriers for cervical cancer screening in marginalized population

2020 ◽  
Vol 9 (12) ◽  
pp. 5006
Author(s):  
Kranti Vora ◽  
Shahin Saiyed ◽  
Rajendra Joshi ◽  
Senthil Natesan
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Large Population ◽  
Population Level ◽  
Cost Effective ◽  
Reproductive Age ◽  
Hpv Testing ◽  
Screening Programs

Background: In India, cervical cancer is the second common cause of cancer deaths among women of reproductive age, with 469 million Indian women at risk. High risk human papillomavirus genotypes mainly 16 and 18 account of cervical cancer. The burden of cervical cancer can be reduced by regular screening of human papillomavirus (HPV). There is no specific national program for cervical cancer screening. Eligible women have limited knowledge of screening and also limited access to preventive screenings.Methods: The study was conducted in the slum areas of Ahmedabad city in Gujarat. 1088 women between 30-45 years of age were recruited in the study and 536 women consented to give cervical samples for DNA based HPV testing. We collected information regarding knowledge and practice for cervical cancer and HPV along with demographic data.Results: Lack of knowledge and practices around cervical cancer and screening among community women was found. There is a lack of awareness about the importance of preventive healthcare and near absence of evidence-based practices. Sociodemographic characteristics are important predictors of participation in the screening program.Conclusions: In the Indian context, HPV testing is a cost-effective option to prevent cervical cancer. The burden of cervical cancer is incredibly high. With increased ability to accurately detect, population level HPV testing would reduce the burden of cervical cancer and the ultimate cost per person would be minimal, due to the country’s large population. There is a need to develop policy to ensure participation of women in the HPV based cervical cancer screening programs.

scholarly journals Performance of an affordable urine self-sampling method for human papillomavirus detection in Mexican women

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254946
Author(s):  
Rubí Hernández-López ◽  
Luis Hermosillo ◽  
Leith León-Maldonado ◽  
Rafael Velázquez-Cruz ◽  
Leticia Torres-Ibarra ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Healthcare Workers ◽  
Sampling Method ◽  
Urine Collection ◽  
Hpv Testing ◽  
Screening Programs ◽  
The Impact

Introduction Urine self-sampling for human papillomavirus (HPV)-based cervical cancer screening is a non-invasive method that offers several logistical advantages and high acceptability, reducing barriers related to low screening coverage. This study developed and evaluated the performance of a low-cost urine self-sampling method for HPV-testing and explored the acceptability and feasibility of potential implementation of this alternative in routine screening. Methods A series of sequential laboratory assays examined the impact of several pre-analytical conditions for obtaining DNA from urine and subsequent HPV detection. Initially, we assessed the effect of ethylaminediaminetetraacetic acid (EDTA) as a DNA preservative examining several variables including EDTA concentration, specimen storage temperature, time between urine collection and DNA extraction, and first-morning micturition versus convenience sample collection. We further evaluated the agreement of HPV-testing between urine and clinician-collected cervical samples among 95 women. Finally, we explored the costs of self-sampling supplies as well as the acceptability and feasibility of urine self-sampling among women and healthcare workers. Results Our results revealed higher DNA concentrations were obtained when using a 40mM EDTA solution, storing specimens at 25°C and extracting DNA within 72 hrs. of urine collection, regardless of using first-morning micturition or a convenience sampling. We observed good agreement (Kappa = 0.72) between urine and clinician-collected cervical samples for HPV detection. Furthermore, urine self-sampling was an affordable method (USD 1.10), well accepted among cervical cancer screening users, healthcare workers, and decision-makers. Conclusion These results suggest urine self-sampling is feasible and appropriate alternative for HPV-testing in HPV-based screening programs in lower-resource contexts.

scholarly journals DETECTION OF HUMAN PAPILLOMA VIRUS BY «SELF SAMPLING»: A NEW MODEL OF CERVICAL CANCER SCREENING

2020 ◽  
Vol 47 (4) ◽  
Author(s):  
O. O. Kovalyov ◽  
N. N. Voloshina ◽  
A. M. Riaboshapka ◽  
K. A. Kovalyov
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Sampling Method ◽  
Pap Test ◽  
Female Population ◽  
Papilloma Virus ◽  
Screening Programs ◽  
Incidence And Mortality

Abstract The article presents the advantages of screening cervical cancer based on the detection of oncogenic strains of human papillomavirus compare to traditional cytological screening using the PAP test. Self sampling using Aprovix's Qvintip tool (Sweden) allows to increase the percentage of women participating in national population screening programs, which will lead to an improvement in the incidence and mortality rates of the female population from cervical cancer. Keywords: cervical cancer screening, human papillomavirus, Self sampling method.

A pilot study of community-based self-sampling for HPV testing among non-attenders of cervical cancer screening programs in El Salvador

2017 ◽  
Vol 138 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Bari Laskow ◽  
Ruben Figueroa ◽  
Karla M. Alfaro ◽  
Isabel C. Scarinci ◽  
Elizabeth Conlisk ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Pilot Study ◽  
El Salvador ◽  
Cervical Cancer Screening ◽  
Hpv Testing ◽  
Community Based ◽  
Screening Programs

Role of Ancillary Techniques in Gynecologic Cytopathology Specimens

2019 ◽  
Vol 64 (1-2) ◽  
pp. 63-70
Author(s):  
Andrea D. Olivas ◽  
Julieta E. Barroeta ◽  
Ricardo R. Lastra
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
High Risk ◽  
Cervical Cancer Screening ◽  
Hpv Testing ◽  
Invasive Procedures ◽  
Ki 67 ◽  
Dual Staining

The association between high-risk genotypes of human papillomavirus (hr-HPV) and cervical cancer is well established. As hr-HPV testing is rapidly becoming a part of routine cervical cancer screening, either in conjunction with cytology or as primary testing, the management of hr-HPV-positive women has to be tailored in a way that increases the detection of cervical abnormalities while decreasing unnecessary colposcopic biopsies or other invasive procedures. In this review, we discuss the overall utility and strategies of hr-HPV testing, as well as the advantages and limitations of potential triage strategies for hr-HPV-positive women, including HPV genotyping, p16/Ki-67 dual staining, and methylation assays.

scholarly journals Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing

Viruses ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 729 ◽  
Author(s):  
Andreas Chrysostomou ◽  
Dora Stylianou ◽  
Anastasia Constantinidou ◽  
Leondios Kostrikis
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Hpv Vaccination ◽  
Screening Method ◽  
Population Based ◽  
Screening Tests ◽  
Screening Methods ◽  
Hpv Testing ◽  
Screening Programs

Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.

scholarly journals Equity in Cervical Cancer Screening in Iran: A Cross-Sectional Analysis of the 2016 Nationwide Steps Survey

2020 ◽  
Author(s):  
Rozhin Amin ◽  
Ali-Asghar Kolahi ◽  
Nader Jahanmehr ◽  
Ali-Reza Abadi ◽  
Mohammad-Reza Sohrabi
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Socioeconomic Factors ◽  
Cervical Cancer Screening ◽  
Concentration Index ◽  
Gis Analysis ◽  
Spatial Disparity ◽  
Cross Sectional ◽  
Screening Programs ◽  
Incidence And Mortality

Abstract Background One of the most important concerns in every healthcare system is the achievement of equity in health. Studies have shown great socioeconomic and spatial disparity in cervical cancer incidence and mortality. This study aims to investigate equity in cervical cancer screening in Iran. Methods A cross-sectional study was conducted using data from the National Non-Communicable Risk Factors Survey in 2016 (STEPs 2016). Data on cervical cancer screening in addition to demographic and socioeconomic factors from 15975 women aged 18 and above were analyzed. Chi-Square test and logistic regression were used to assess the association of demographic and socioeconomic factors with cervical cancer screening. Equity in screening was assessed by concentration index, and GIS analysis was used to show the provincial indices on the map of Iran. Results Overall, 41·6% of surveyed women in Iran had undergone cervical cancer screening in their lifetime. Participation rate in cervical cancer screening programs varied between provinces; ranging from 7.6% in Sistan and Baluchestan to 61.2% in Isfahan. Being single, living in rural areas, young age, having no education, and being uninsured were associated with lower participation. Concentration index showed pro-poor inequity for the country and across all provinces, indicating that cervical cancer screening services are less utilised by high income groups. GIS analysis demonstrated spatial disparity across provinces of Iran. Conclusions Equity and participation in cervical cancer screening in Iran requires improvement. For this to be achieved, new policies shall have a stronger emphasis on the lowest and the highest socioeconomic population groups, while current strategies have mostly affected the people with middle socioeconomic status.

scholarly journals De-implementation and Substitution of Clinical Care Processes: Stakeholder Perspectives on the Transition to Primary Human Papillomavirus (HPV) Testing for Cervical Cancer Screening

2021 ◽  
Author(s):  
Erin E Hahn ◽  
Corrine Munoz-Plaza ◽  
Danielle Altman ◽  
Chunyi Hsu ◽  
Nancy Cannizzaro ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Clinical Practice ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Readiness To Change ◽  
Barriers And Facilitators ◽  
Hpv Testing ◽  
Cost Cutting ◽  
Hpv Test

Abstract Background: New cervical cancer screening guidelines recommend primary human papillomavirus (HPV) testing for women age 30-65 years. Healthcare organizations are preparing to de-implement the previous recommended strategies of Pap testing or co-testing (Pap plus HPV test) and substitute primary HPV testing. However, there may be significant challenges to replacement of this entrenched clinical practice, even with an evidence-based substitution. We sought to identify stakeholder-perceived barriers and facilitators to this substitution within a large healthcare system, Kaiser Permanente Southern California.Methods: We conducted semi-structured qualitative interviews with clinician, administrative and patient stakeholders regarding: (a) acceptability and feasibility of the planned substitution; (b) perceptions of barriers and facilitators, with an emphasis on those related to the de-implementation/implementation cycle of substitution; and (c) perceived readiness to change. Our interview guide was informed by the Consolidated Framework for Implementation Research (CFIR). Using a team coding approach, we developed an initial coding structure refined during iterative analysis; the data were subsequently organized thematically into domains, key themes, and sub-themes using thematic analysis, followed by framework analysis informed by CFIR.Results: We conducted 23 interviews: 5 patient and 18 clinical/administrative. Clinicians perceived that patients feel more tests equals better care, and clinicians and patients expressed fear of missed cancers (“…it’ll be more challenging convincing the patient that only one test is…good enough to detect cancer.”). Patients perceived practice changes resulting in “less care” are driven by desire to cut costs. In contrast, clinicians/administrators viewed changing from two tests to one as acceptable and a workflow efficiency (“…It’s very easy and half the work.”). Stakeholder-recommended strategies included focusing on the increased efficacy of primary HPV testing and developing clinician talking points incorporating national guidelines to assuage ‘cost-cutting’ fears. Conclusions: Substitution to replace an entrenched clinical practice is complex. Leveraging available facilitators is key to ease the process for clinical and administrative stakeholders—e.g., emphasizing the efficiency of going from two tests to one. Identifying and addressing clinician and patient fears regarding cost-cutting and perceived poorer quality of care is critical for substitution. Multicomponent and multilevel strategies for engagement and education will be required.Trial registration: ClinicalTrials.gov #NCT04371887

scholarly journals Methodologies of Primary HPV Testing Currently Applied for Cervical Cancer Screening

Life ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 290
Author(s):  
Andreas C. Chrysostomou ◽  
Leondios G. Kostrikis
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Test ◽  
Population Based ◽  
World Health ◽  
Hpv Testing ◽  
Screening Programs ◽  
European Guidelines ◽  
Health Organization

The human papillomavirus is one of the most common sexually transmitted viruses, and an infection from this virus may become persistent, leading to diseases such as cervical cancer. In the past, cytology-based methods such as the Papanicolaou (Pap) test were imperative to identify the disease at a stage where it can be treated. However, since the 1980s where the etiological association of HPV and cervical cancer was identified, new tests began emerging directed towards identifying the virus. Furthermore, as the biology of HPV along with the relationships with its host are elucidated, these tests and treatments further advance. Recently in Europe, there is a movement towards the implementation of HPV testing methodologies in national screening programs to precede cytological testing. These screening strategies are recommended by the European guidelines and the World Health Organization. This review presents the current HPV testing methodologies, their application in organized population-based cervical cancer screening programs based on the most recent European guidelines, and their implementation status in countries in Europe.

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