Comparison of cervical cancer screening by self-sampling papillomavirus test versus pap-smear in underprivileged women in France

Abstract Background The purpose of this study was to compare cervical cancer screening by pap smear (PS) versus preliminary HPV testing based on self-collected samples (SC-HPV). Methods Interventional study among underprivileged women from 25 to 65 years old in four French cities. The control group (CG) was referred for a PS. The experimental group (EG) conducted a SC-HPV test followed by a PS in case of positivity. Differences on screening completion and cytological abnormalities were analysed by logistic and Cox regression. Results 383 women were assigned to the EG and 304 to the CG. The screening completion proportion was 39.5% in the CG compared to 71.3% in the EG (HR = 2.48 (CI 95% [1.99–3.08]; p < 0.001). The proportion of cytological abnormalities was 2.0% in the CG and 2.3% in the EG (OR = 1.20 (CI 95% [0.42–3.40]; p = 0.7). The proportion of participants lost to follow-up was 60.5% in the CG and 63.2% in the EG HPV positive (p = 0.18). Conclusion Providing an SC-HPV-test increased the participation of underprivileged women in CCS. Nevertheless, the significant number of lost to follow-up in both groups can undermine the initial benefits of the strategy for HPV positive women. Registration: Clinicaltrials.gov: NCT03118258.

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Lost-to-follow-up for cervical cancer screening

Cancer Research, Statistics, and Treatment ◽

10.4103/crst.crst_46_21 ◽

2021 ◽

Vol 4 (1) ◽

pp. 159

Author(s):

SP Somashekhar ◽

Geetu Bhandoria ◽

Vijay Ahuja

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Lost To Follow Up

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Improving Rates of Cervical Cancer Screening and Pap Smear Follow-Up for Low-Income Women with Limited Health Literacy

Cancer Investigation ◽

10.1081/cnv-100102558 ◽

2001 ◽

Vol 19 (3) ◽

pp. 316-323 ◽

Cited By ~ 37

Author(s):

Stacy T. Lindau ◽

C. Tomori ◽

M. A. McCarville ◽

C. L. Bennett

Keyword(s):

Cervical Cancer ◽

Health Literacy ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Low Income ◽

Pap Smear ◽

Limited Health Literacy ◽

Low Income Women ◽

Limited Health

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Effectiveness of One-Way Text Messaging on Attendance to Follow-Up Cervical Cancer Screening Among Human Papillomavirus–Positive Tanzanian Women (Connected2Care): Parallel-Group Randomized Controlled Trial (Preprint)

10.2196/preprints.15863 ◽

2019 ◽

Author(s):

Ditte S Linde ◽

Marianne S Andersen ◽

Julius Mwaiselage ◽

Rachel Manongi ◽

Susanne K Kjaer ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Controlled Trial ◽

Intervention Group ◽

Text Messages ◽

Control Group ◽

Randomized Controlled ◽

Parallel Group

BACKGROUND Rapid human papillomavirus (HPV) DNA testing is an emerging cervical cancer screening strategy in resource-limited countries, yet it requires follow-up of women who test HPV positive. OBJECTIVE This study aimed to determine if one-way text messages improved attendance to a 14-month follow-up cervical cancer screening among HPV-positive women. METHODS This multicenter, parallel-group randomized controlled trial was conducted at 3 hospitals in Tanzania. Eligible participants were aged between 25 and 60 years, had tested positive to a rapid HPV test during a patient-initiated screening, had been informed of their HPV result, and had a private mobile phone with a valid number. Participants were randomly assigned in a 1:1 ratio to the intervention or control group through an incorporated algorithm in the text message system. The intervention group received one-way text messages, and the control group received no text messages. The primary outcome was attendance at a 14-month health provider-initiated follow-up screening. Participants were not blinded, but outcome assessors were. The analysis was based on intention to treat. RESULTS Between August 2015 and July 2017, 4080 women were screened for cervical cancer, of which 705 were included in this trial—358 women were allocated to the intervention group, and 347 women were allocated to the control group. Moreover, 16 women were excluded before the analysis because they developed cervical cancer or died (8 from each group). In the intervention group, 24.0% (84/350) women attended their follow-up screening, and in the control group, 23.8% (80/335) women attended their follow-up screening (risk ratio 1.02, 95% CI 0.79-1.33). CONCLUSIONS Attendance to a health provider-initiated follow-up cervical cancer screening among HPV-positive women was strikingly low, and one-way text messages did not improve the attendance rate. Implementation of rapid HPV testing as a primary screening method at the clinic level entails the challenge of ensuring a proper follow-up of women. CLINICALTRIAL ClinicalTrials.gov NCT02509702; https://clinicaltrials.gov/ct2/show/NCT02509702. INTERNATIONAL REGISTERED REPORT RR2-10.2196/10.2196/15863

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Loss to Follow-Up in a Cervical Cancer Screening and Treatment Program in Western Kenya

Journal of Global Oncology ◽

10.1200/jgo.18.41300 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 97s-97s ◽

Cited By ~ 1

Author(s):

S. Kiptoo ◽

G. Otieno ◽

P. Tonui ◽

A. Mwangi ◽

O. Orango ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Treatment Program ◽

Cox Regression ◽

P Value ◽

Western Kenya ◽

Loss To Follow Up ◽

Follow Up Care

Background: Increasingly, evidence is emerging from developing countries like Kenya on the burden of loss to follow-up care after a positive cervical cancer screening/diagnosis, which impacts negatively on cervical cancer prevention and control. Unfortunately little or no information exists on the subject in the western region of Kenya. This study is designed to determine the proportion of and predictors and reasons for defaulting from follow-up care after positive cervical cancer screen. Aim: To determine the rates and factors associated with loss to follow-up in a multivisit cervical cancer screening and treatment program in western Kenya. Methods: We conducted a prospective study of women, who presented for cervical cancer screening at Chulaimbo and Webuye subcounty hospitals, and screened positive by VIA. A 2-3 weeks appointment was then set for review by a gynae-oncologist. A total of 100 women, scheduled for review, were recruited in the study and followed between August 2016 and May 2017. LTFU was defined as failure to keep a second rescheduled appointment or being unreachable for 3 consecutive months and failure to confirm that a woman sought for care in another health facility. Descriptive statistics was used for summary and the Cox regression model was used to estimate the risk of LTFU for different covariates. Results: The age range was 21-77 years, with a mean of 44.45 years. 39% of the women defaulted from scheduled follow-up appointment of which 25 (64%) were LTFU. Univariate Cox regression was conducted for HIV cases (HR=2.7, P value=0.021), clinic revisits (HR=2.6, P value=0.026), married (HR=0.63, P value=0.237) and previously screened women (HR=1.67, P value=0.198). Increased risk of LTFU was observed for HIV cases (HR=2.4, P value=0.04) and revisits (HR=7.5, P value=0.014) in an adjusted model. Conclusion: LTFU affects cervical cancer management due to several factors some of which are beyond the control of the women. We recommend a larger study be replicated for ease of generalizability of results; awareness and strategies are required to retain them to obey the treatment appointment since they are the highly vulnerable.

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Framing preventive care messaging and cervical cancer screening in a health-insured population in South Africa: Implications for population-based communication?

Journal of Health Psychology ◽

10.1177/1359105316628735 ◽

2016 ◽

Vol 22 (11) ◽

pp. 1365-1375 ◽

Cited By ~ 5

Author(s):

Leegale Adonis ◽

Jithen Paramanund ◽

Debashis Basu ◽

John Luiz

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Pap Smear ◽

Message Framing ◽

Population Based ◽

Control Group ◽

Health Message ◽

The Impact ◽

Control Study

The impact of health message framing on cervical cancer screening uptake is poorly understood. In a prospective randomized control study with 748 females, aged 21–65 years with no Pap smear in the previous 3 years, they randomly received a loss-framed, gain-framed, or neutral health message (control) regarding cervical cancer screening by email. Screening rate in the control group was 9.58 percent (CI: 9.29%–9.87%), 5.71 percent (CI: 5.48%–6.98%) in the gain-framed group, and 8.53 percent (CI: 8.24%–8.81%) in the loss-framed group. Statistically there was no difference between the three screening rates. Framing of health messages may not be a significant consideration when communicating through emails.

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Effectiveness of a health education program to improve health literacy among females in their 20s: A quasi-experimental study

10.21203/rs.2.10319/v1 ◽

2019 ◽

Author(s):

Shiho Kawata ◽

Emiko Saito

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Scale Score ◽

Sex Education ◽

Intervention Group ◽

Medical Practitioner ◽

Control Group ◽

Significant Difference

Abstract Background Japanese women cervical cancer rates are rising aged 20-30 years, few opportunities for sex education of appropriate for age are provided to females. Health literacy (HL) is an important concept in women’s health. To improve HL for cervical cancer prevention, we developed a health program for females in their 20s. This study aimed to examine the effectiveness of the program. Methods A quasi-experimental design with control groups was conducted on female undergraduate students. The inclusion criteria for both groups were: (i) Japanese females, (ii) aged 20 years or older. The sample size for each group was set at ≥13 people based in a previous study. The participants were evaluated HL variables: HL scale score, confidence in explaining one’s own body to a medical practitioner (Y/N), knowledge of women’s health, and indicated whether they had undergone cervical cancer screening. Assessments were conducted baseline and 6 months after (follow-up) the program was implemented. Analysis of the results consisted of calculating intergroup comparisons of HL variables at follow-up using the Mann-Whitney U test and Fisher’s exact test or chi-square test. Results 14 students for the intervention group participated in the study, while 60 students for the control group participated. Intergroup pair matching using the variables of concern for one’s own body and HL scale score yielded a total final analysis population of 28 participants (n=14 in each group). Comparison of both groups at follow-up revealed a significant difference in median HL scale score, at 66 in the intervention group versus 60 in the control group (P=.002), also a significant difference in the percentage of participants who felt confident in explaining their own body to a medical practitioner (P<.001), and median knowledge score was 16 in the intervention group and 14 in the control group, which was significantly different (P=.008). There were no significant intergroup differences in cervical cancer screening behaviors. Conclusions The results indicated that the program was effective in improving HL, but was not effective in changing cervical cancer screening behavior. Further research is needed to determine how to provide appropriate sex education among females in their 20s.

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Effectiveness of One-Way Text Messaging on Attendance to Follow-Up Cervical Cancer Screening Among Human Papillomavirus–Positive Tanzanian Women (Connected2Care): Parallel-Group Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/15863 ◽

2020 ◽

Vol 22 (4) ◽

pp. e15863 ◽

Cited By ~ 1

Author(s):

Ditte S Linde ◽

Marianne S Andersen ◽

Julius Mwaiselage ◽

Rachel Manongi ◽

Susanne K Kjaer ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Controlled Trial ◽

Intervention Group ◽

Text Messages ◽

Control Group ◽

Randomized Controlled ◽

Parallel Group

Background Rapid human papillomavirus (HPV) DNA testing is an emerging cervical cancer screening strategy in resource-limited countries, yet it requires follow-up of women who test HPV positive. Objective This study aimed to determine if one-way text messages improved attendance to a 14-month follow-up cervical cancer screening among HPV-positive women. Methods This multicenter, parallel-group randomized controlled trial was conducted at 3 hospitals in Tanzania. Eligible participants were aged between 25 and 60 years, had tested positive to a rapid HPV test during a patient-initiated screening, had been informed of their HPV result, and had a private mobile phone with a valid number. Participants were randomly assigned in a 1:1 ratio to the intervention or control group through an incorporated algorithm in the text message system. The intervention group received one-way text messages, and the control group received no text messages. The primary outcome was attendance at a 14-month health provider-initiated follow-up screening. Participants were not blinded, but outcome assessors were. The analysis was based on intention to treat. Results Between August 2015 and July 2017, 4080 women were screened for cervical cancer, of which 705 were included in this trial—358 women were allocated to the intervention group, and 347 women were allocated to the control group. Moreover, 16 women were excluded before the analysis because they developed cervical cancer or died (8 from each group). In the intervention group, 24.0% (84/350) women attended their follow-up screening, and in the control group, 23.8% (80/335) women attended their follow-up screening (risk ratio 1.02, 95% CI 0.79-1.33). Conclusions Attendance to a health provider-initiated follow-up cervical cancer screening among HPV-positive women was strikingly low, and one-way text messages did not improve the attendance rate. Implementation of rapid HPV testing as a primary screening method at the clinic level entails the challenge of ensuring a proper follow-up of women. Trial Registration ClinicalTrials.gov NCT02509702; https://clinicaltrials.gov/ct2/show/NCT02509702. International Registered Report Identifier (IRRID) RR2-10.2196/10.2196/15863

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Self-Sampling for HPV Testing: Increased Cervical Cancer Screening Participation and Incorporation in International Screening Programs

10.20944/preprints201711.0199.v2 ◽

2017 ◽

Author(s):

Sarah Gupta ◽

Christina Palmer ◽

Elisabeth M. Bik ◽

Juan P. Cardenas ◽

Harold Nuñez ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Pap Smear ◽

Precancerous Lesions ◽

Hpv Infection ◽

Nucleic Acid Amplification ◽

Hpv Testing ◽

Screening Programs

In most industrialized countries, screening programs for cervical cancer have shifted from cytology (Pap smear or ThinPrep) alone on clinician-obtained samples to the addition of screening for human papillomavirus (HPV), its main causative agent. For HPV testing, self-sampling instead of clinician-sampling has proven to be equally accurate, in particular for assays that use nucleic acid amplification techniques. In addition, HPV testing of self-collected samples in combination with a follow-up Pap smear in case of a positive result is more effective in detecting precancerous lesions than a Pap smear alone. Self-sampling for HPV testing has already been adopted by some countries, while others have started trials to evaluate its incorporation into national cervical cancer screening programs. Self-sampling may result in more individuals willing to participate in cervical cancer screening, because it removes many of the barriers that prevent women, especially those in low socioeconomic and minority populations, from participating in regular screening programs. Several studies have shown that the majority of women who have been underscreened but who tested HPV-positive in a self-obtained sample, will visit a clinic for follow-up diagnosis and management. Additionally, a self-collected sample can also be used for vaginal microbiome analysis, which can provide additional information about HPV infection persistence as well as vaginal health in general.

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