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

Viruses ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 729 ◽  
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.

scholarly journals Methodologies of Primary HPV Testing Currently Applied for Cervical Cancer Screening

Life ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 290
Author(s):  
Andreas C. Chrysostomou ◽  
Leondios G. Kostrikis
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Test ◽  
Population Based ◽  
World Health ◽  
Hpv Testing ◽  
Screening Programs ◽  
European Guidelines ◽  
Health Organization

The human papillomavirus is one of the most common sexually transmitted viruses, and an infection from this virus may become persistent, leading to diseases such as cervical cancer. In the past, cytology-based methods such as the Papanicolaou (Pap) test were imperative to identify the disease at a stage where it can be treated. However, since the 1980s where the etiological association of HPV and cervical cancer was identified, new tests began emerging directed towards identifying the virus. Furthermore, as the biology of HPV along with the relationships with its host are elucidated, these tests and treatments further advance. Recently in Europe, there is a movement towards the implementation of HPV testing methodologies in national screening programs to precede cytological testing. These screening strategies are recommended by the European guidelines and the World Health Organization. This review presents the current HPV testing methodologies, their application in organized population-based cervical cancer screening programs based on the most recent European guidelines, and their implementation status in countries in Europe.

scholarly journals The Clinical Role of HPV Testing in Primary and Secondary Cervical Cancer Screening

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
G. Hoste ◽  
K. Vossaert ◽  
W. A. J. Poppe
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Screening Methods ◽  
Hpv Testing ◽  
Clinical Role ◽  
Screening Programs ◽  
Hpv Test

Traditional population-based cervical screening programs, based on cytology, have successfully reduced the burden of cervical cancer. Nevertheless limitations remain and new screening methods are emerging. Despite vaccination against the 2 most oncogenic types (HPV 16/18), cervical cancer screening will have to continue as an essential public health strategy. As the acquisition of an HR-HPV infection is critical in the progression to (pre-)cancerous cervical lesions, recent research has focused on HR-HPV detection. The sensitivity of HPV testing in primary and secondary prevention outweighs that of cytology, at the cost of slightly lower specificity. Although most of the HR-HPV infections are cleared after conization, new evidence from numerous studies encourages the implementation of HR-HPV testing and genotyping to improve posttreatment surveillance. An HR-HPV test 6 months after conization is a promising useful clinical marker to detect persistence and prevent progression. This review highlights the clinical role of HPV testing in primary and secondary cervical cancer screening.

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

2017 ◽  
Vol 6 (2) ◽  
pp. 51 ◽  
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.

A pilot study of community-based self-sampling for HPV testing among non-attenders of cervical cancer screening programs in El Salvador

2017 ◽  
Vol 138 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Bari Laskow ◽  
Ruben Figueroa ◽  
Karla M. Alfaro ◽  
Isabel C. Scarinci ◽  
Elizabeth Conlisk ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Pilot Study ◽  
El Salvador ◽  
Cervical Cancer Screening ◽  
Hpv Testing ◽  
Community Based ◽  
Screening Programs

scholarly journals Awareness of carcinoma cervix in nursing personnel of a tertiary care institute, Mumbai, India

2017 ◽  
Vol 7 (1) ◽  
pp. 128
Author(s):  
Pooja K. Bandekar ◽  
Prashant B. Kale
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Carcinoma ◽  
Nursing Staff ◽  
Tertiary Care ◽  
Screening Methods ◽  
Carcinoma Cervix ◽  
Indian Women ◽  
Screening Programs

Background: Carcinoma cervix is the second most common cancer of women all over the world and commonest cancer among Indian women. Awareness about cervical cancer and its prevention low amongst Indian women. The Pap test is a simple cost-effective technique for screening to help early diagnosis of cervical cancer. Nursing staff should be made aware of cervical cancer, so that they can spread the knowledge to the general public. Objectives of present study were to assess the knowledge level regarding symptoms, risk factors, prevention and screening of cervical carcinoma among nursing staff and to find out the behaviour of respondents regarding prevention and screening of cervical carcinomaMethods: A cross-sectional interview-based survey regarding knowledge of cervical carcinoma was conducted among the nursing staff of a tertiary care institutes of Mumbai.A structured questionnaire with multiple choices was used as a tool for data collection. Provision for open-ended responses was also made in the questionnaire. 100 nurses participated in the current study. Data was entered in Microsoft Excel. SPSS statistical software was used to generate statistical parameters like proportion, mean, standard deviation, etc. The test of significance used was the Z test and a P value of <0.05 was considered as the level of significance.Results: We lack an organized opportunistic screening program for cervical cancer in India. Data indicates a slow, but steady, decline in the incidence of cervical cancer. However, the rates are still too high, particularly in the rural areas. It is extremely essential to screen eligible women when they come to health units for other services. Studies have shown it is possible to train nurses to screen for cervical cancer. Attitudes that screening is to be done by doctors or gynaecologists only needs to change. The survey revealed that the hospital played a limited role as a source of information on Pap smear. This calls for a re-orientation of nurses, paramedicals and health workers and a need for introduction of simpler cervical cancer screening methods such as visual inspections that are more sustainableConclusions: Awareness about cervical cancer has to be improved. Education of the nursing personel will strongly contribute to strengthen cervical cancer screening programs. Nursing staff can and should educate the masses to help increase health awareness in women.

scholarly journals Prospective cohort study examining cervical cancer screening methods in HIV-positive and HIV-negative Cambodian Women: a comparison of human papilloma virus testing, visualization with acetic acid and digital colposcopy

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e026887 ◽  
Author(s):  
Sovannara Thay ◽  
Andrew Goldstein ◽  
Lena Sophia Goldstein ◽  
Vaishnavi Govind ◽  
Kruy Lim ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Cohort Study ◽  
Cancer Screening ◽  
Human Papilloma Virus ◽  
Cervical Cancer Screening ◽  
Screening Methods ◽  
Hpv Testing ◽  
Papilloma Virus ◽  
Hiv Women

ObjectivesLogistical and economic issues make traditional cytology-based cervical cancer screening challenging in developing countries. Alternative, cost-effective, screening strategies must be developed to screen millions of women in resource-poor countries such as Cambodia.DesignA prospective cohort study during which all women underwent four cervical cancer screening methods: (1) self-sampled human papilloma virus (HPV) testing (careHPV system), (2) clinician-collected HPV testing, (3) visualization with acetic acid (VIA) and (4) digital colposcopy (DC) with the Enhanced Visual Assessment System (EVA).SettingA referral hospital in Phnom Penh, Cambodia.ParticipantsTwo hundred and fifty Cambodian women (129 HIV+, 121 HIV-). Subjects were recruited from the National Center for HIV/AIDS Dermatology and sexually transmitted disease (STD) cohort, the Sihanouk Hospital Center of Hope’s Rural Outreach Teams and the Pochentong Medical Center.ResultsFifty six of the 250 (22.4%) patients tested positive for high-risk HPV (hrHPV+). Thirty seven of the 129 HIV+ women were hrHPV+ (28.6%) whereas 19/121 HIV- women were hrHPV+ (15.7%) p=0.0154. Self-sampling HPV specimens identified 50/56 (89%) whereas physician-collected specimens identified 45/56 (80%) p=0.174. 95.2% of the patients felt comfortable obtaining HPV self-samples. Thirty seven of 250 women were VIA+. Thirty of 37 VIA+ women underwent confirmatory biopsies for cervical intraepithelial neoplasia (CIN) (26 CIN1, 4 CIN2+). The rate of confirmed dysplasia in the HIV+ group was 20/129 (15.5%) compared with 10/121 (8.26%) in HIV- women p=0.0291. The contemporaneous physician impressions of the DC images accurately differentiated between CIN1 and CIN2+ lesions in all 30 women having confirmatory biopsies.ConclusionsThe results of this study suggest potential modifications of the current cervical screening strategy that is currently being employed in Cambodia. The first step in this new strategy would be self-swabbing for hrHPV. Subsequently, hrHPV+ patients would have DC and immediate treatment based on colposcopic findings: cryotherapy for suspected CIN1 and loop electrosurgical excision procedure (LEEP) for suspected CIN2+.

Identification of ideal strategy of cervical cancer screening in Japan based on Fukui cervical cancer screening study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17025-e17025
Author(s):  
Tetsuji Kurokawa ◽  
Akiko Shinagawa ◽  
Yoko Chino ◽  
Motohiro Kobayashi ◽  
Yoshio Yoshida
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Positive Predictive Value ◽  
Cervical Cancer Screening ◽  
Predictive Value ◽  
Screening Method ◽  
Hpv Testing ◽  
Abnormal Cytology ◽  
Predictive Values ◽  
Hpv Status

e17025 Background:The estimated age-standardized incidence rate for cervical cancer is higher in Japan than in North America and the UK. It is important to improve cancer screening. The introduction of HPV testing with cytology for triage of those that test positive for cervical cancer screening has been challenging. The Fukui Cervical Cancer Screening (FCCS) study was designed to determine the best cervical cancer screening method in the Japanese population. We performed a subanalysis using baseline data of FCCS study to determine the performance of cytology, the human papillomavirus (HPV) testing and cotesting with cytology and HPV testing, and to evaluate whether the stratification of HPV16, HPV18, and 12 other hrHPV types appropriately balances risks and harms in the Japanese cancer screening population. Methods:The study enrolled 7,584 women aged 25 years or older undergoing routine screening. All women underwent liquid-based cytology (LBC) and cobas HPV testing. Women with abnormal cytology regardless of the HPV status, women with positive hrHPV results regardless of cytology results, and women randomly selected from among those with normal cytology and negative hrHPV results were referred for colposcopy. Results:The prevalence of hrHPV, HPV16, and HPV18 was 6.8%, 1.2%, and 0.5%, respectively. The estimated sensitivities for cervical intraepithelial neoplasia (CIN) 2 or worse for cytology, HPV testing, and cotesting with cytology and HPV testing were 71%, 92%, and 100%, respectively. The estimated positive predictive values for cytology, HPV testing, and cotesting with cytology and HPV testing were 33%, 21% and 21%, respectively. Using a strategy whereby those with abnormal cytology or positive HPV16 genotype undergo colposcopy and biopsy results in a sensitivity of 85% and a positive predictive value of 33%. This strategy results in improved sensitivity while at the same time maintains the positive predictive value compared to screening with cytology alone. Conclusions:Baseline data from the FCCS study suggests that strategy of using colposcopy for women with abnormal cytology and/or HPV16 positivity appropriately balances risks and harms for Japanese women. Clinical trial information: UMIN000025977.

Compliance with Breast and Cervical Cancer Screening Programs in Women: Results from a Population-Based Study

2013 ◽  
Vol 99 (5) ◽  
pp. 565-571 ◽  
Author(s):  
Rossana Berardi ◽  
Dania Nacciarriti ◽  
Tiziana Tamburrano ◽  
Giovanna Carbonari ◽  
Emanuela Romagnoli ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Population Based ◽  
Population Based Study ◽  
Screening Programs ◽  
Breast And Cervical Cancer

scholarly journals Psycho-Social Factors Influencing Cervical Cancer Screening and Human Papilloma Virus Vaccination Acceptance Among Female Civil Servants in Delta State, Nigeria

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 21s-21s ◽  
Author(s):  
B. Ohaeri ◽  
P. Ebunu ◽  
C. Ndikom
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Human Papilloma Virus ◽  
Cervical Cancer Screening ◽  
Social Factors ◽  
Hpv Vaccination ◽  
Civil Servants ◽  
Sub Saharan Africa ◽  
Screening Tests ◽  
Papilloma Virus

Background: Cervical cancer is the fourth most common cancer affecting women worldwide and most notable in low and middle income countries of sub-Saharan Africa. There are 528000 new cases estimated globally every year. The crude incidence rate of cervical cancer is 5.8% worldwide, 19% in West Africa, and 19.3% in Nigeria. In Nigeria, uptake of cervical cancer screening and HPV vaccination has been demonstrated in different studies to be very low, out of thirteen studies, nine show cervical cancer screening uptake of less than 5.3%. Psycho-social factors such as anxiety, stigmatization, poor health seeking behaviors and lack of family and social support among others, have been implicated. Therefore, this study assessed the psycho-social barriers to utilization of cervical cancer screening services and uptake of vaccination among female civil servants in Delta state. Aim: To assess the psycho-social factors that impede the utilization of cervical cancer screening and HPV vaccination among female civil servants in Delta state. Methods: A descriptive, cross-sectional, nonexperimental design was used for this study. Multi-stage sampling technique was used in selecting 437 women who consented, based on a calculated sample size. Thereafter, 437 self-administered structured questionnaires with a reliability coefficient of 0.7, were administered to participants, out of which 435 were retrieved. This gave a response rate of 99.5%. Data collected were analyzed with the aid of Statistical Package for Social Sciences (SPSS) using descriptive statistics and χ2. Results: Many participants (55.4%) knew about cervical cancer; 93.6% had never been screened for cervical cancer, while 94.7% had not vaccinated their teenage girls against human papilloma virus. Among the psycho-social factors highlighted that impeded the utilization of services were, costs of the screening tests (54.5%) and HPV vaccine (51.3%), while 58.2% reported inaccessibility. However, majority (73.6%) were willing to go for the cervical cancer screening and vaccination of their teenagers (68%). Conclusion: Cervical cancer screening and subsequent vaccination are strategies focused at ensuring reduction in the incidence of cervical cancer in the society to the barest minimum. Creating awareness about cervical cancer could be a means to help tackle the lack of knowledge issue, thereby increasing knowledge. In addition, subsidization will go a long way in lessening the financial burden, as well as increase utilization. Subsequently, global burden of cervical cancer will be reduced, with a consequent reduction in mortality.

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