Vaccination against HPV: indications for women and the impact on the cervical screening programme

Background English cervical screening programme guidelines changed between 2009 and 2012. We explore the impact on the age and intervals at which women receive a cytology test. Methods Eligible women were controls from a population-based case–control study in England. Tests taken between 1980 and 2017 were extracted from the call/recall database. Using the Kaplan–Meier estimator by birth cohort and age at (or time since) last test, we explore proportions tested since or prior to a given age, years since previous test, and interval following a negative test. Results Screening histories from 46,037 women were included. Proportion tested by age 26 has increased from 55% among birth cohorts 1978–1979 to 67% among those born 1990–1991, despite more recent cohorts only having received one invitation (instead of two) prior to age 26. The proportion of women tested at aged 28 with a test three years earlier increased by 20% (from 36% in 1997–2006 to 56% in 2012–2017) whereas the proportion tested at ages 23–27 without a prior test increased from 34% to 80%. The age at last test prior to exiting the programme has decreased: among those born 1928–1931 86% had a test aged 60–65, but only 71% of those born 1947–1951. Conclusion Clear programme guidance alongside quality assurance has improved the cervical screening programme by standardising the age and intervals at which women are screened.

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The impact of the COVID-19 pandemic on organised cervical cancer screening: The first results of the Slovenian cervical screening programme and registry

The Lancet Regional Health - Europe ◽

10.1016/j.lanepe.2021.100101 ◽

2021 ◽

Vol 5 ◽

pp. 100101

Author(s):

Urška Ivanuš ◽

Tine Jerman ◽

Urška Gašper Oblak ◽

Leon Meglič ◽

Mojca Florjančič ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Screening Programme ◽

Cervical Screening ◽

First Results ◽

The Impact

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Maximising the acceptability of extended time intervals between screens in the NHS Cervical Screening Programme: An online experimental study

Journal of Medical Screening ◽

10.1177/0969141320970591 ◽

2020 ◽

pp. 096914132097059

Author(s):

Emily Hill ◽

Martin Nemec ◽

Laura Marlow ◽

Susan Mary Sherman ◽

Jo Waller

Keyword(s):

Online Survey ◽

Screening Programme ◽

Cervical Screening ◽

Group Differences ◽

Basic Information ◽

Cross Sectional ◽

Screening Interval ◽

Group 3 ◽

The Impact ◽

Group 1

Objective The NHS Cervical Screening Programme plans to increase the screening interval from 3 to 5 years for women aged 25–49 who test negative for human papillomavirus (HPV). This exploratory cross-sectional online survey tested the impact of different levels of information about the proposed change on acceptability of a longer interval. Methods Women aged 18–45 (n = 585) were individually randomised to one of three information exposure groups differing in the level of information provided about the screening interval change: (1) basic information; (2) basic information with additional detail about timeline of HPV infection; (3) as (2) but with the addition of a diagram. Acceptability of the change ( favourable and unfavourable attitudes) was assessed post-exposure alongside HPV timeline beliefs. We used ANOVA and regression analyses to test for between-group differences. Results Women in Group 3 had higher scores on the favourable attitudes sub-scale compared with Group 1. Women in Groups 2 and 3 had more accurate timeline beliefs than those in Group 1. There were no between-group differences in unfavourable attitudes. After adjusting for demographic factors, a higher favourable attitudes score was independently predicted by being in Group 3 compared to Group 1, more accurate HPV timeline beliefs, and previous irregular or non-attendance at screening. Conclusions Overall, acceptability of an increased screening interval was moderate, but providing women with information about the safety and rationale for this change may improve acceptability. In particular, communicating the long timeline from HPV exposure to cervical cancer may reassure women about the safety of the proposed changes.

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Use of the Aptima mRNA high-risk human papillomavirus (HR-HPV) assay compared to a DNA HR-HPV assay in the English cervical screening programme: a decision tree model based economic evaluation

BMJ Open ◽

10.1136/bmjopen-2019-031303 ◽

2020 ◽

Vol 10 (3) ◽

pp. e031303 ◽

Cited By ~ 2

Author(s):

Georgie Weston ◽

Caroline Dombrowski ◽

Michael J Harvey ◽

Thomas Iftner ◽

Maria Kyrgiou ◽

...

Keyword(s):

High Risk ◽

Decision Tree ◽

Messenger Rna ◽

Screening Programme ◽

Cervical Screening ◽

Cost Savings ◽

Hypothetical Cohort ◽

Tree Model ◽

Dna Assay ◽

The Impact

ObjectiveTo estimate the impact of using the Aptima messenger RNA (mRNA) high-risk human papilloma virus (HR-HPV) assay versus a DNA HR-HPV assay in a primary HPV cervical screening programme.DesignOne hypothetical cohort followed for 3 years through HPV primary cervical screening.SettingEngland.ParticipantsA hypothetical cohort of women aged 25–65 years tested in the National Health Service (NHS) Cervical Screening Programme (CSP) for first call or routine recall testing.MethodsA decision tree parameterised with data from the CSP (2017/18) and the HORIZON study. Uncertainty analyses were conducted using data from the FOCAL and GAST studies, other DNA HPV tests in addition to one-way and probabilistic sensitivity and scenarios analyses, to test the robustness of results.InterventionsAptima mRNA HR-HPV assay and a DNA HR-HPV assay (cobas 4800 HPV assay).Main outcome measuresPrimary: total colposcopies and total costs for the cohort. Secondary: total HPV and cytology tests, number lost to follow-up.ResultsAt baseline for a population of 2.25 million women, an estimated £15.4 million (95% credibility intervals (CI) £6.5 to 24.1 million) could be saved and 28 009 (95% CI 27 499 to 28 527) unnecessary colposcopies averted if Aptima mRNA assays are used instead of a DNA assay, with 90 605 fewer unnecessary HR-HPV and 253 477 cytology tests performed. These savings are due to a lower number of HPV positive samples in the mRNA arm. When data from other primary HPV screening trials were compared, results indicated that using the Aptima mRNA assay generated cost savings and reduced testing in every scenario.ConclusionUsing the Aptima mRNA assay versus a DNA assay would almost certainly yield cost savings and reduce unnecessary testing and procedures, benefiting the NHS and women in the CSP.

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The impact of Jade Goody's diagnosis and death on the NHS Cervical Screening Programme

Journal of Medical Screening ◽

10.1258/jms.2012.012028 ◽

2012 ◽

Vol 19 (2) ◽

pp. 89-93 ◽

Cited By ~ 39

Author(s):

L Lancucki ◽

P Sasieni ◽

J Patnick ◽

Tj Day ◽

Mp Vessey

Keyword(s):

Screening Programme ◽

Cervical Screening ◽

The Impact

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The impact of a television soap opera on the NHS Cervical Screening Programme in the North West of England

Journal of Public Health ◽

10.1093/pubmed/24.4.299 ◽

2002 ◽

Vol 24 (4) ◽

pp. 299-304 ◽

Cited By ~ 34

Author(s):

A. Howe ◽

V. Owen-Smith ◽

J. Richardson

Keyword(s):

Screening Programme ◽

Cervical Screening ◽

Soap Opera ◽

North West ◽

The North ◽

The Impact

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Cervical screening in Solomon Islands: challenges and opportunities for a national screening programme

Development in Practice ◽

10.1080/09614524.2021.1907541 ◽

2021 ◽

pp. 1-13

Author(s):

Jessica R. Botfield ◽

Catherine McGowan ◽

Verlyn Gagahe ◽

Faeha Tashkeel ◽

Anne Stuart

Keyword(s):

Screening Programme ◽

Solomon Islands ◽

Cervical Screening ◽

Challenges And Opportunities

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Cervical pap smears and pandemics: The effect of COVID-19 on screening uptake & opportunities to improve

Women s Health ◽

10.1177/17455065211017070 ◽

2021 ◽

Vol 17 ◽

pp. 174550652110170

Author(s):

Hannah Masson

Keyword(s):

Human Papilloma Virus ◽

Cervical Screening ◽

High Sensitivity ◽

Health Board ◽

Pap Smears ◽

Local Health ◽

Papilloma Virus ◽

Face To Face ◽

Screening Uptake ◽

The Impact

Background: The Coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented upheaval within global healthcare systems and resulted in the temporary pausing of the National Health Service (NHS) Scotland Cervical Screening Programme. With several months of backlogs in appointments, there has not only been a reduction in primary samples being taken for human papilloma virus (HPV) testing but there have also been fewer women referred to colposcopy for investigation and treatment of precancerous or cancerous changes as a result. Encouraging uptake for cervical screening was always a priority before the pandemic, but it is even more important now, considering that the fears and barriers to screening that women may have are now exacerbated by COVID-19. Objectives: This article explores the impact of the pandemic on the uptake of cervical screening within NHS Ayrshire & Arran and evaluates potential strategies to improve uptake now and in future such as self-sampling and telemedicine. Methods: This article presents evidence-based literature and local health board data relating to cervical screening during the pandemic. Results: Human papilloma virus self-sampling carried out by the woman in her home has been shown to improve uptake, especially in non-attenders, whilst maintaining a high sensitivity and, crucially, reducing the need for face-to-face contact. Increased education is key to overcoming barriers women have to screening and telemedicine can strengthen engagement with women during this time. Conclusion: There are lessons to be learned from the pandemic, and we must use this opportunity to improve cervical screening uptake for the future.

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