Understanding HPV and cervical screening

2022 ◽  
Vol 33 (1) ◽  
pp. 14-17
Author(s):  
Sarah Butler ◽  
Yvonne Wilkinson
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Screening Programme ◽  
Cervical Screening ◽  
Cervical Cancers ◽  
Primary Screening ◽  
Primary Test ◽  
Hpv Screening ◽  
Cervical Cells

Cervical cancer is preventable and curable. Sarah Butler and Yvonne Wilkinson explain how the cervical screening programme has changed from a cytology based test to HPV primary screening Screening for human papillomavirus is now the primary test for cervical screening in England, Wales and Scotland. Cervical screening for those individuals with a cervix routinely occurs every 3 years for those aged 25–49 (24½ in England) and every 5 years for those aged 50–64. Over 99.7% of cervical cancers are caused by human papillomavirus. Cervical cancer is preventable and curable; primary HPV screening can detect early changes in cervical cells allowing for effective monitoring and treatment.

Interval cancer audit and disclosure in cervical screening programmes: An international survey

2021 ◽  
pp. 096914132110623
Author(s):  
Patricia Fitzpatrick ◽  
Therese Mooney ◽  
Helen Byrne ◽  
Orla Healy ◽  
Noirin Russell ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Detection ◽  
Cervical Screening ◽  
Interval Cancer ◽  
Population Based ◽  
Audit Process ◽  
Detection Rates ◽  
Legal Cases ◽  
Cervical Cancers ◽  
International Comparative

Background Legal cases involving the National Cervical Screening Programme in Ireland following non-disclosure of an interval cervical cancer audit prompted this first international comparative survey of interval cervical cancer audit. Methods A survey of 22 international population-based cervical screening programmes was conducted, to determine if they undertook audit of invasive cervical cancers. Those countries/regions that perform reviews were asked (i) how the audit was undertaken, including how the reviews were performed and how they controlled for retrospective bias, (ii) how women are informed of the audit process and how their consent is obtained, and (iii) how audit results were disclosed to patients. Results Seventeen countries/regions invited completed the survey (77%); 65% (11/17) have an audit process for interval cervical cancers. Five perform individual patient reviews; three perform programme-wide review, with calculation of interval cancer detection rates; one routinely performs programme-wide review with calculation of interval cancer detection rates and offers individual reviews, and one routinely performs local hospital-level reviews. In the remaining country/region, hospital laboratories audit cancers, with a national audit process for all cervical cancers. Varying methodologies for retrospective cytology review were employed; four include control samples, with a ratio varying from 1:1 to 1:2. Three conduct a blinded review. Most countries/regions do not discuss interval cancer audit with participants and 3/11 (27.3%) inform women when a cervical cancer audit takes place. Disclosure is limited and variable. Conclusion The responses suggest that there is no consistent approach to audit of interval cervical cancers or to disclosure of audit results.

scholarly journals Strategies to reach marginalized women for cervical cancer screening: A qualitative study of stakeholder perspectives

2018 ◽  
Vol 25 (1) ◽  
pp. 8 ◽  
Author(s):  
B. Wood ◽  
A. Lofters ◽  
M. Vahabi
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Qualitative Study ◽  
Cervical Cancer Screening ◽  
Health Care Providers ◽  
Cervical Screening ◽  
Primary Care Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Primary Screening

Background Self-sampling for human papillomavirus (hpv) has the potential to reach marginalized populations that are underserved for cervical cancer screening. However, before implementing an alternative screening strategy such as self-sampling for under- and never-screened women, the key processes, facilitators, and barriers to reform need to be understood.Methods A descriptive qualitative study was conducted that involved semi-structured interviews with Canadian and international cancer screening health care providers and policy-makers. Respondents were purposively selected from a list of thirty stakeholders generated through an environmental scan. The interviews were transcribed verbatim and analyzed using directed content analysis.Results Nineteen stakeholders participated in the interviews. Most respondents thought that self-sampling was an appropriate cervical screening alternative for hard-to-reach populations, as it addressed barriers to cervical screening related to various social determinants of health. All respondents emphasized that transitioning to hpv primary screening would catalyze a policy shift towards self-sampling. Clinician respondents were less enthusiastic about self-sampling strategies since that discouraged women’s appointments with primary care providers, because cervical screening offered an opportunity to discuss other preventive health topics. There also was little consensus between respondents on whether the state of evidence was satisfactory to integrate a self-sampling option into policy, or whether more Canadian research was needed.Conclusion Canadian cervical cancer screening stakeholders should collaborate to identify the knowledge gaps that researchers should address and leverage the existing literature to implement tailored, patient-centred alternative cervical screening strategies. The transition to hpv primary screening would be a key first step in the broad implementation of hpv self-sampling in Canada.

Cervical cancer screening programme

2019 ◽  
Vol 13 (11) ◽  
pp. 526-533
Author(s):  
Ian Peate
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Screening Programme ◽  
Cervical Screening ◽  
Signs And Symptoms ◽  
Increased Risk ◽  
Cancer Screening Programme ◽  
Cervical Cancer Screening Programme ◽  
The Uk

Screening for cervical cancer saves lives. This article provides an overview of cervical screening programmes offered by the NHS. All four countries in the UK provide a cervical cancer screening programme. Cervical screening identifies apparently healthy women who may be at increased risk of a disease or condition; this then provides an opportunity for earlier treatment or better informed decisions. In some instances, the healthcare assistant and assistant practitioner (HCA and AP) may be needed in order to provide assistance with the screening procedure, offering the woman physical and psychological support. This article offers the reader an overview of the cervix, along with a brief description of signs and symptoms of cervical cancer.

scholarly journals Self-Collection for Cervical Screening Programs: From Research to Reality

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1053 ◽  
Author(s):  
David Hawkes ◽  
Marco H. T. Keung ◽  
Yanping Huang ◽  
Tracey L. McDermott ◽  
Joanne Romano ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cervical Screening ◽  
Scale Up ◽  
Public Health Problem ◽  
Routine Laboratory ◽  
Major Barrier ◽  
Screening Programs ◽  
Speculum Examination ◽  
Primary Screening ◽  
High Negative Predictive Value

In 2018, there were an estimated 570,000 new cases of cervical cancer globally, with most of them occurring in women who either had no access to cervical screening, or had not participated in screening in regions where programs are available. Where programs are in place, a major barrier for women across many cultures has been the requirement to undergo a speculum examination. With the emergence of HPV-based primary screening, the option of self-collection (where the woman takes the sample from the vagina herself) may overcome this barrier, given that such samples when tested using a PCR-based HPV assay have similar sensitivity for the detection of cervical pre-cancers as practitioner-collected cervical specimens. Other advantages of HPV-based screening using self-collection, beyond the increase in acceptability to women, include scalability, efficiency, and high negative predictive value, allowing for long intervals between negative tests. Self-collection will be a key strategy for the successful scale up of cervical screening programs globally in response to the WHO call for all countries to work towards the elimination of cervical cancer as a public health problem. This review will examine self-collection for HPV-based cervical screening including the collection devices, assays and possible routine laboratory processes considering how they can be utilized in cervical screening programs.

OP67 Cost-Effectiveness of Human Papillomavirus-based Primary Cervical Screening In Ireland

2017 ◽  
Vol 33 (S1) ◽  
pp. 28-29
Author(s):  
Michelle O'Neill ◽  
Linda Murphy ◽  
Patricia Harrington ◽  
Gaby Sroczynski ◽  
Mairin Ryan
Keyword(s):  
Human Papillomavirus ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Optimal Strategy ◽  
Screening Test ◽  
Current Practice ◽  
Cervical Screening ◽  
Cost Effective ◽  
Primary Screening ◽  
Triage Test

INTRODUCTION:The cost-effectiveness of Human papillomavirus (HPV)-based primary cervical screening in the Irish healthcare setting is assessed using a decision-analysis approach to inform a decision around changes to the national screening program. Current practices comprises primary screening with liquid-based cytology (LBC) followed by HPV triage, at 3-yearly intervals for ages 25 to 45 years and 5-yearly until age 60 years.METHODS:This study assessed changing the primary screening test from LBC to HPV testing, in both an unvaccinated and a vaccinated (against HPV 16/18) cohort. It considered extending the screening interval (to 5-yearly for all), the upper age limit (from 60 to 65 years) and different test sequences (four possible tests were included: HPV, LBC, partial genotyping for HPV16 or HPV 18 and the molecular biomarker p16INK4a/Ki67). A Markov-model for HPV-infection and cervical cancer was developed based on a German cervical screening model (1). The perspective of the healthcare system was adopted and a 5 percent discount rate used.RESULTS:Strategies using HPV as the primary screening test are more effective than LBC-based strategies. The optimal strategy, at a willingness-to-pay threshold of EUR45,000 per quality-adjusted life year (QALY), for the unvaccinated cohort was HPV-based primary screening with a LBC triage test, at five-yearly intervals from age 25 to 60 years. This strategy is cost saving compared with current practice and cost effective when compared to no screening, with an Incremental cost-effectiveness ratio (ICER) of EUR18,164 per QALY. The optimal strategy for the vaccinated cohort was also HPV primary screening with a LBC triage test, at five-yearly intervals from age 25 to 60 years. While more effective and cost saving compared with current practice, it would not be considered cost effective compared with no screening (ICER of EUR58,745/QALY).CONCLUSIONS:Based on our analyses, HPV-based cervical screening is more effective and cost saving compared with LBC-based screening for both vaccinated and unvaccinated cohorts in an Irish setting.

Human papillomavirus testing for primary screening in women at low risk of developing cervical cancer. The Greek experience

2005 ◽  
Vol 96 (3) ◽  
pp. 714-720 ◽  
Author(s):  
T. Agorastos ◽  
K. Dinas ◽  
B. Lloveras ◽  
S. de Sanjose ◽  
J.R. Kornegay ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Low Risk ◽  
Primary Screening ◽  
Human Papillomavirus Testing
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