A population‐based combination strategy to improve the cervical cancer screening coverage rate in Bamako, Mali

Abstract Background The World Health Organisation (WHO) calls for the elimination of cervical cancer (CC) as a public health issue. To achieve elimination, efforts must be aligned and accelerated. Women living with HIV (WLWH) have excess risk for developing, and dying from, CC over the general population. Estimates of cervical cancer screening programme coverage in Eastern European countries that have experienced HIV epidemics since the early 2000’s are scarce. Method This population-based retrospective study uses a healthcare administrative database and follows cohorts of all WLWH in a ratio of 1:3 randomly matched (age, region) HIV negative women from 2009 to 2018. Annual and longitudinal (over the whole study period) coverage for cervical cancer screening (opportunistic, organised, HIV specific) and adjusted odds ratios (AORs) for longitudinal screening coverage predictors were estimated from 2009 to 2018. Results Among WLWH and HIV-negative women, the mean annual coverage with opportunistic screening was 61.45 and 65.59%; and organised screening was 20.4 and 28.7%, respectively (both: p < 0.00001). 19.01% (95% CI 18.05–19.97) HIV-negative and 13.9% (95% CI 12.35–15.45) WLWH were longitudinally covered with organised cervical cancer screening. Among WLWH, the mean annual HIV-specific cervical cancer screening coverage was 49.4, and 24.3% were longitudinally covered. Longitudinal coverage with HIV-specific cervical cancer screening was inversely associated with age, hepatitis C virus (HCV) co-infection (AOR 0.754, 95% CI 0.619, 0.916), not having insurance (AOR 0.331, 95% CI 0.264, 0.412), drug abuse (AOR 0.459, 95% CI 0.336, 0.618) and higher among those retained in HIV care (AOR 1.972, 95% CI 1.615, 2.410). Among HIV-negative women, longitudinal coverage with organised cervical cancer screening was inversely associated with residence in the region and higher among older women. Conclusions Our results highlight unacceptably low coverage of cervical cancer screening of WLWH in Estonia. There is need for dedicated cervical cancer screening efforts for WLWH considering the high cancer risk and rate in the study population.

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Effect of introducing human papillomavirus genotyping into real-world screening on cervical cancer screening in China: a retrospective population-based cohort study

Therapeutic Advances in Medical Oncology ◽

10.1177/17588359211010939 ◽

2021 ◽

Vol 13 ◽

pp. 175883592110109

Author(s):

Binhua Dong ◽

Huachun Zou ◽

Xiaodan Mao ◽

Yingying Su ◽

Hangjing Gao ◽

...

Keyword(s):

Cervical Cancer ◽

Cohort Study ◽

Human Papillomavirus ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Cox Regression ◽

Intraepithelial Neoplasia ◽

Population Based ◽

Hpv Genotyping ◽

Cytology Screening

Background: China’s Fujian Cervical Pilot Project (FCPP) transitioned cervical cancer screening from high-risk human papillomavirus (HR-HPV) nongenotyping to genotyping. We investigated the clinical impact of this introduction, comparing performance indicators between HR-HPV genotyping combined with cytology screening (HR-HPV genotyping period) and the previous HR-HPV nongenotyping combined with cytology screening (HR-HPV nongenotyping period). Methods: A retrospective population-based cohort study was performed using data from the FCPP for China. We obtained data for the HR-HPV nongenotyping period from 1 January 2012 to 31 December 2013, and for the HR-HPV genotyping period from 1 January 2014 to 31 December 2016. Propensity score matching was used to match women from the two periods. Multivariable Cox regression was used to assess factors associated with cervical intraepithelial neoplasia of grade 2 or worse (CIN2+). The primary outcome was the incidence of CIN2+ in women aged ⩾25 years. Performance was assessed and included consistency, reach, effectiveness, adoption, implementation and cost. Results: Compared with HR-HPV nongenotyping period, in the HR-HPV genotyping period, more CIN2+ cases were identified at the initial screening (3.06% versus 2.32%; p < 0.001); the rate of colposcopy referral was higher (10.87% versus 6.64%; p < 0.001); and the hazard ratio of CIN2+ diagnosis was 1.64 (95% confidence interval, 1.43–1.88; p < 0.001) after controlling for health insurance status and age. The total costs of the first round of screening (US$66,609 versus US$65,226; p = 0.293) were similar during the two periods. Higher screening coverage (25.95% versus 25.19%; p = 0.007), higher compliance with age recommendations (92.70% versus 91.69%; p = 0.001), lower over-screening (4.92% versus 10.15%; p < 0.001), and reduced unqualified samples (cytology: 1.48% versus 1.73%, p = 0.099; HR-HPV: 0.57% versus 1.34%, p < 0.001) were observed in the HR-HPV genotyping period. Conclusions: Introduction of an HR-HPV genotyping assay in China could detect more CIN2+ lesions at earlier stages and improve programmatic indicators. Evidence suggests that the introduction of HR-HPV genotyping is likely to accelerate the elimination of cervical cancer in China.

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Clinical evaluation of p16 INK4a immunocytology in cervical cancer screening: A population‐based cross‐sectional study from rural China

Cancer Cytopathology ◽

10.1002/cncy.22428 ◽

2021 ◽

Author(s):

Remila Rezhake ◽

Yan Wang ◽

Feng Chen ◽

Shang‐Ying Hu ◽

Xun Zhang ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Clinical Evaluation ◽

Rural China ◽

Population Based ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

P16 Ink4a

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Automated Quantitative Cytology Imaging Analysis System in Cervical Cancer Screening in Shanxi Province, China

Cancer and Clinical Oncology ◽

10.5539/cco.v6n2p51 ◽

2017 ◽

Vol 6 (2) ◽

pp. 51 ◽

Cited By ~ 1

Author(s):

Yan Dong ◽

Jigeng Bai ◽

Yuping Zhang ◽

Guangjie Shang ◽

Yan Zhao ◽

...

Keyword(s):

Artificial Intelligence ◽

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Population Based ◽

Shanxi Province ◽

Detection Rates ◽

Screening Programs ◽

Quantitative Cytology ◽

Automated Platform

Purpose: In China the number of pathologists is far from being enough to meet the demands of ongoing population based cervical cancer screening programs. This article aims to present our experience with automated quantitative cytology imaging platform, a reading system with an artificial intelligence that we currently use routinely for cervical cancer screening in Shanxi province.Methods: From 2012-2016 a total of 40 178 women were screened. Women were divided into three groups and each group had two subgroups. Smear and liquid based technique were compared using manual and automated platform.Results: Detection rates of CIN2 + and positive rates of CIN2 were higher in all three groups when automated quantitative cytology platform was used compared with groups where reading was done by the pathologist using conventional microscope. Operator’s costs associated with automated quantitative cytology platform vs. conventional reading using light microscope were compared too. The overall costs of operations based on automated platform were proven to be lower.Conclusion: The use of automated platform and artificial intelligence as a means to overcome the lack of cytotechnologists and pathologists and to implement proper quality control in the large scale population based cervical cancer screening seems very promising.

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Clinical follow-up practices after cervical cancer screening by co-testing: A population-based study of adherence to U.S. guideline recommendations

Preventive Medicine ◽

10.1016/j.ypmed.2021.106770 ◽

2021 ◽

Vol 153 ◽

pp. 106770

Author(s):

Rebecca B. Perkins ◽

Rachael Adcock ◽

Vicki Benard ◽

Jack Cuzick ◽

Alan Waxman ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Population Based ◽

Population Based Study

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

Viruses ◽

10.3390/v10120729 ◽

2018 ◽

Vol 10 (12) ◽

pp. 729 ◽

Cited By ~ 42

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.

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