scholarly journals Integrating HPV vaccination programs with enhanced cervical cancer screening and treatment, a systematic review

Vaccine ◽  
2021 ◽  
Author(s):  
Charlotte Wirtz ◽  
Yasmin Mohamed ◽  
Danielle Engel ◽  
Anissa Sidibe ◽  
Megan Holloway ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Hpv Vaccination ◽  
Vaccination Programs

scholarly journals Cost-effectiveness of human papillomavirus vaccine in China: a systematic review of modelling studies

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052682
Author(s):  
Wenchuan Shi ◽  
Xiaoli Cheng ◽  
Haitao Wang ◽  
Xiao Zang ◽  
Tingting Chen
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Study Quality ◽  
The Cost

ObjectivesChina suffers from high burdens of human papillomavirus (HPV) and cervical cancer, whereas the uptake of HPV vaccine remains low. The first Chinese domestic HPV vaccine was released in 2019. However, collective evidence on cost-effectiveness of HPV vaccination in China has yet to be established. We summarised evidence on the cost-effectiveness of HPV vaccine in China.DesignSystematic review and narrative synthesisData sourcesPubMed, EMBASE, China National Knowledge Infrastructure and Wanfang Data were searched through 2 January 2021Eligibility criteria for selecting studiesCost-effectiveness studies using a modelling approach focusing on HPV vaccination interventions in the setting of China were included for review.Data extraction and synthesisWe extracted information from the selected studies focusing on cost-effectiveness results of various vaccination programmes, key contextual and methodological factors influencing cost-effectiveness estimates and an assessment of study quality.ResultsA total of 14 studies were included for review. Considerable heterogeneity was found in terms of the methodologies used, HPV vaccination strategies evaluated and study quality. The reviewed studies generally supported the cost-effectiveness of HPV vaccine in China, although some reached alternative conclusions, particularly when assessed incremental to cervical cancer screening. Cost of vaccination was consistently identified as a key determinant for the cost-effectiveness of HPV vaccination programmes.ConclusionsImplementing HPV vaccination programmes should be complemented with expanded cervical cancer screening, while the release of lower-priced domestic vaccine offers more promising potential for initiating public HPV vaccination programmes. Findings of this study contributes important evidence for policies for cervical cancer prevention in China and methodological implications for future modelling efforts.

The Pittsburgh Cervical Cancer Screening Model: A Risk Assessment Tool

2010 ◽  
Vol 134 (5) ◽  
pp. 744-750
Author(s):  
R. Marshall Austin ◽  
Agnieszka Onisko ◽  
Marek J. Druzdzel
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Disease Risk ◽  
Hpv Vaccination ◽  
Dynamic Bayesian Network ◽  
Adenocarcinoma In Situ ◽  
Test Results ◽  
Hpv Test

Abstract Context.—Evaluation of cervical cancer screening has grown increasingly complex with the introduction of human papillomavirus (HPV) vaccination and newer screening technologies approved by the US Food and Drug Administration. Objective.—To create a unique Pittsburgh Cervical Cancer Screening Model (PCCSM) that quantifies risk for histopathologic cervical precancer (cervical intraepithelial neoplasia [CIN] 2, CIN3, and adenocarcinoma in situ) and cervical cancer in an environment predominantly using newer screening technologies. Design.—The PCCSM is a dynamic Bayesian network consisting of 19 variables available in the laboratory information system, including patient history data (most recent HPV vaccination data), Papanicolaou test results, high-risk HPV results, procedure data, and histopathologic results. The model's graphic structure was based on the published literature. Results from 375 441 patient records from 2005 through 2008 were used to build and train the model. Additional data from 45 930 patients were used to test the model. Results.—The PCCSM compares risk quantitatively over time for histopathologically verifiable CIN2, CIN3, adenocarcinoma in situ, and cervical cancer in screened patients for each current cytology result category and for each HPV result. For each current cytology result, HPV test results affect risk; however, the degree of cytologic abnormality remains the largest positive predictor of risk. Prior history also alters the CIN2, CIN3, adenocarcinoma in situ, and cervical cancer risk for patients with common current cytology and HPV test results. The PCCSM can also generate negative risk projections, estimating the likelihood of the absence of histopathologic CIN2, CIN3, adenocarcinoma in situ, and cervical cancer in screened patients. Conclusions.—The PCCSM is a dynamic Bayesian network that computes quantitative cervical disease risk estimates for patients undergoing cervical screening. Continuously updatable with current system data, the PCCSM provides a new tool to monitor cervical disease risk in the evolving postvaccination era.

scholarly journals International barriers and facilitators for cervical cancer screening among young people: a systematic review

2021 ◽  
Author(s):  
Abirami Kirubarajan ◽  
Shannon Leung ◽  
Xinglin Li ◽  
Matthew Yau ◽  
Mara Sobel
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Young People ◽  
Cervical Cancer Screening ◽  
Low Income ◽  
Healthcare Providers ◽  
Barriers And Facilitators ◽  
Low Income Countries ◽  
Age Group

Background Though cervical cancer is one of the leading causes of death globally, its incidence is nearly entirely preventable. Young people have been an international priority for screening. However, in both high-income and low-income countries, young people have not been screened appropriately according to country-specific guidelines and in many countries, screening rates for this age-group have even dropped. Objectives The aim of this systematic review was to systematically characterize the existing literature on barriers and facilitators for cervical cancer screening among young people globally. Search Strategy We conducted a systematic review following PRISMA guidelines of four databases: Medline-OVID, EMBASE, CINAHL, and ClinicalTrials.Gov. Selection Criteria We only examined original, peer-reviewed literature. Databases were examined from inception until the date of our literature searches (12/03/2020). Articles were excluded if they did not specifically discuss cervical cancer screening, were not specific to young people, or did not report outcomes or evaluation. Data Collection and Analysis All screening and extraction was completed in duplicate with two independent reviewers. Main Results Of the 2177 original database citations, we included 36 studies that met inclusion criteria. Our systematic review found that there are three large categories of barriers for young people: lack of knowledge/awareness, negative perceptions of the test, and practical barriers to testing. Facilitators included stronger relationships with healthcare providers, social norms, support from family, and self-efficacy. Conclusions Health systems worldwide should address the barriers and facilitators to increase cervical cancer screening rates in young people. Further research is required to understand this age group.

scholarly journals Self-sampling for human papillomavirus (HPV) testing: a systematic review and meta-analysis

2019 ◽  
Vol 4 (3) ◽  
pp. e001351 ◽  
Author(s):  
Ping Teresa Yeh ◽  
Caitlin E Kennedy ◽  
Hugo de Vuyst ◽  
Manjulaa Narasimhan
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Clinical Assessment ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Hpv Testing ◽  
Screening Uptake ◽  
Screening Frequency

IntroductionHuman papillomavirus (HPV) self-sampling test kits may increase screening for and early detection of cervical cancer and reduce its burden globally. To inform WHO self-care guidelines, we conducted a systematic review and meta-analysis of HPV self-sampling among adult women on cervical (pre-)cancer screening uptake, screening frequency, social harms/adverse events and linkage to clinical assessment/treatment.MethodsThe included studies compared women using cervical cancer screening services with HPV self-sampling with women using standard of care, measured at least one outcome, and were published in a peer-reviewed journal. We searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CNIAHL), Latin American and Caribbean Health Sciences Literature (LILACS) and Embase through October 2018. Risk of bias was assessed using the Cochrane tool for randomised controlled trials (RCTs) and the Evidence Project tool for non-randomised studies. Meta-analysis was conducted using random-effects models to generate pooled estimates of relative risk (RR).Results33 studies in 34 articles with 369 017 total participants met the inclusion criteria: 29 RCTs and 4 observational studies. All studies examined HPV self-sampling; comparison groups were standard of care (eg, Pap smear, visual inspection with acetic acid, clinician-collected HPV testing). 93% of participants were from high-income countries. All 33 studies measured cervical cancer screening uptake. Meta-analysis found greater screening uptake among HPV self-sampling participants compared with control (RR: 2.13, 95% CI 1.89 to 2.40). Effect size varied by HPV test kit dissemination method, whether mailed directly to home (RR: 2.27, 95% CI 1.89 to 2.71), offered door-to-door (RR: 2.37, 95% CI 1.12 to 5.03) or requested on demand (RR: 1.28, 95% CI 0.90 to 1.82). Meta-analysis showed no statistically significant difference in linkage to clinical assessment/treatment between arms (RR: 1.12, 95% CI 0.80 to 1.57). No studies measured screening frequency or social harms/adverse events.ConclusionA growing evidence base, mainly from high-income countries and with significant heterogeneity, suggests HPV self-sampling can increase cervical cancer screening uptake compared with standard of care, with a marginal effect on linkage to clinical assessment/treatment.Systematic review registration numberPROSPERO CRD42018114871.

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