Companies and health insurance associations should not adopt the cytological self-sampling method for cervical cancer screening

Objective. To assess willingness to participate and diagnostic accuracy of visual inspection for early detection of cervical neoplasia among women in a health insurance company.Patients and Method. Cervical cancer screening was systematically proposed to 800 women after consecutive information and awareness sessions. The screening method was visual inspection with acetic acid (VIA) or Lugol’s iodine (VILI).Results. Among the 800 identified women, 640 (82%) have accepted the screening, their mean age was 39 years, and 12.0% of them were involved in a polygamist couple. 28.2% of women had prior cervical screening. VIA has been detected positive in 5.9% of women versus 8.6% for VILI. The sensitivity was 72.9% and specificity was 95.2% for VIA versus 71.2% and 97.3% for VILI respectively. The histological examination highlighted a nonspecific chronic cervicitis in 4.6%, CIN1 lesions in 5.91%, and CIN2/3 in 1.2% of the cases.Conclusion. Cervical cancer screening by visual inspection showed appropriate diagnostic accuracy when used to detect early cervical lesions. It is a simple and easy to perform method that could be introduced progressively in the health insurance policy while waiting for a national screening program.

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Cervical Cancer Screening Financing in Indonesia

Journal of Global Oncology ◽

10.1200/jgo.18.22700 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 93s-93s ◽

Cited By ~ 1

Author(s):

M. Wahidin

Keyword(s):

Primary Care ◽

Cervical Cancer ◽

Health Insurance ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

National Health Insurance ◽

Cervical Screening ◽

Health Centers ◽

Primary Health ◽

Care Facilities

Background: Indonesia has been developing social health insurance as attempt of universal health coverage with target of 100% population by 2019. The coverage was for all diseases from primary care until secondary care. Cervical cancer screening was among these which were covered by the insurance. In line with national program of cervical cancer screening, the insurance will strengthen the development of the program. As a new concept of financing - started in 2014- it need to know many circumstances of cervical cancer screening financing in Indonesia. Aim: The study was aimed to know overview of cervical cancer screening financing in Indonesia. Methods: Design of the study was descriptive study through literature review from related sources. Secondary data were collected from Directorate of Noncommunicable Disease Control and Center of Health Financing, Ministry of Health, and National Health Insurance Body (BPJS). The study was conducted in January- February 2018. Results: Cancer was ranked number 3 of highest claim for national health insurance with total IDR 1.54 trillion in 2014, became IDR 2.3 trillion in 2015. Number of cases of cancer, as claimed in hospitals, was also increasing from 702,207 cases in 2014 became 1,325,776 cases in 2015. Cervical cancer was among the highest claim. Based on Minister of Health Decree No. 52/2016 about tariff of healthcare in social health insurance, cervical cancer screening was covered by the insurance. Tariff of visual inspection with acetic acid (VIA) was maximum IDR 25,000 (USD 2), tariff of Papanicolaou test was maximum IDR 125,000 (USD 10), and tariff of cryotherapy of positive VIA was IDR 150,000 (USD 11.5). These tariffs can be claimed by providers of cervical screening in primary care facilities to BPJS through noncapitation scheme. This scheme was number of claim financing by BPJS to primary health centers according to type and number of health services. Mechanism of claiming was conducted by screening providers to financing officers in primary health centers using specific form to be sent to BPJS. Then, BPJS will process payment for accepted claim. Number of population became of BPJS in 2017 was 187.9 million out of 257 million target (73%). Meanwhile number of primary care facilities collaborated with BPJS was 20,708 (including 9813 primary health centers) out of 24,336 primary care facilities (84%). It means the financing of cervical screening could be used as optimal as possible to achieve national target of screening which was 37.4 million women aged 30-50 years. Conclusion: Cervical cancer screening financing was covered by national health insurance in Indonesia. Majority of primary care facility collaborated with BPJS which become strengthening factor to enhance achievement of national target of cervical screening.

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Performance of an affordable urine self-sampling method for human papillomavirus detection in Mexican women

PLoS ONE ◽

10.1371/journal.pone.0254946 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254946

Author(s):

Rubí Hernández-López ◽

Luis Hermosillo ◽

Leith León-Maldonado ◽

Rafael Velázquez-Cruz ◽

Leticia Torres-Ibarra ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Healthcare Workers ◽

Sampling Method ◽

Urine Collection ◽

Hpv Testing ◽

Screening Programs ◽

The Impact

Introduction Urine self-sampling for human papillomavirus (HPV)-based cervical cancer screening is a non-invasive method that offers several logistical advantages and high acceptability, reducing barriers related to low screening coverage. This study developed and evaluated the performance of a low-cost urine self-sampling method for HPV-testing and explored the acceptability and feasibility of potential implementation of this alternative in routine screening. Methods A series of sequential laboratory assays examined the impact of several pre-analytical conditions for obtaining DNA from urine and subsequent HPV detection. Initially, we assessed the effect of ethylaminediaminetetraacetic acid (EDTA) as a DNA preservative examining several variables including EDTA concentration, specimen storage temperature, time between urine collection and DNA extraction, and first-morning micturition versus convenience sample collection. We further evaluated the agreement of HPV-testing between urine and clinician-collected cervical samples among 95 women. Finally, we explored the costs of self-sampling supplies as well as the acceptability and feasibility of urine self-sampling among women and healthcare workers. Results Our results revealed higher DNA concentrations were obtained when using a 40mM EDTA solution, storing specimens at 25°C and extracting DNA within 72 hrs. of urine collection, regardless of using first-morning micturition or a convenience sampling. We observed good agreement (Kappa = 0.72) between urine and clinician-collected cervical samples for HPV detection. Furthermore, urine self-sampling was an affordable method (USD 1.10), well accepted among cervical cancer screening users, healthcare workers, and decision-makers. Conclusion These results suggest urine self-sampling is feasible and appropriate alternative for HPV-testing in HPV-based screening programs in lower-resource contexts.

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Cervical cancer screening in rural NSW: Health Insurance Commission data compared to self-report

Australian and New Zealand Journal of Public Health ◽

10.1111/j.1467-842x.1998.tb01382.x ◽

1998 ◽

Vol 22 (3) ◽

pp. 307-312 ◽

Cited By ~ 8

Author(s):

Lynne Hancock ◽

Rob Sanson-Fisher ◽

Lynne Kentish

Keyword(s):

Cervical Cancer ◽

Health Insurance ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Self Report

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Persistent Disparities in Cervical Cancer Screening Uptake: Knowledge and Sociodemographic Determinants of Papanicolaou and Human Papillomavirus Testing Among Women in the United States

Public Health Reports ◽

10.1177/0033354920925094 ◽

2020 ◽

Vol 135 (4) ◽

pp. 483-491

Author(s):

Nicole L. Johnson ◽

Katharine J. Head ◽

Susanna Foxworthy Scott ◽

Gregory D. Zimet

Keyword(s):

United States ◽

Cervical Cancer ◽

Health Insurance ◽

Human Papillomavirus ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Pap Test ◽

The United States ◽

Populations At Risk ◽

Hpv Test

Objectives Cervical cancer is the second-most common type of cancer among women aged 15-44, and racial, ethnic, and economic disparities exist in survival rates despite widely available screening tests and early treatment options. The objective of this study was to describe the association among knowledge, sociodemographic characteristics, and cervical cancer screening, with the goal of developing interventions to prevent cervical cancer in populations at risk of the disease. Methods In 2017, we conducted a nationwide survey of women in the United States aged ≥18 who had ever received a Papanicolaou (Pap) test (N = 630). We conducted t tests and one-way analysis of variance to determine sociodemographic differences (age, education, race, ethnicity, income, type of health insurance) in knowledge about cervical cancer screening (Pap test and human papillomavirus [HPV] test). We used logistic regressions to define significant determinants of cervical cancer screening behaviors in the previous 5 years. Results Of 629 respondents, 407 (64.7%) had an annual household income <$30 000, and 322 of 536 (60.1%) respondents had government-provided health insurance. Of 630 women who had ever had a Pap test, 425 (67.5%) had an HPV test. Hispanic and non-Hispanic white women were more likely than Hispanic and non-Hispanic black women (odds ratio [OR] = 2.49; 95% CI, 1.12-4.54; P = .02) and women with government-provided health insurance (OR = 1.91; 95% CI, 1.08-3.37; P = .03) were more likely than women with private health insurance to have received a Pap test in the previous 5 years. Knowledge of HPV was a significant predictor of having received an HPV test in the previous 5 years (OR = 1.37; 95% CI, 1.22-1.54; P < .001). Conclusion Disparities in cervical cancer screening among sociodemographic groups of women suggest the need for targeted interventions to improve knowledge about Pap and HPV tests.

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