Introduction of HPV testing for cervical cancer screening in The Scale-Up project Central America: The Scale-Up project

PREVENTIVE MEDICINE

卷:135

Article

Holme, Francesca¹  Jeronimo, Jose²  Maldonado, Francisco³  Camel, Claudia⁴  Sandoval, Manuel⁵  Martinez-Granera, Benito³  Montenegro, Mirna⁶  Figueroa, Jacqueline⁷  Slavkovsky, Rose¹  Thomson, Kerry A.¹  de Sanjose, Silvia¹ 

[1] PATH, Seattle, WA USA

[2] Jose Jeronimo Consulting, Damascus, MD USA

[3] Movicanc, Managua, Nicaragua

[4] Minist Publ Hlth & Social Assistance, Guatemala City, Guatemala

[5] Assoc Hondurena Planificac Familia, Tegucigalpa, Honduras

[6] Instancia Salud & Desarrollo Mujeres, Guatemala City, Guatemala

[7] Secretary Hlth, Tegucigalpa, Honduras

关键词: Screening;    HPV;    Cervical cancer;    Thermal ablation;    Health information system;   

DOI  :  10.1016/j.ypmed.2020.106076

来源: Elsevier

【 摘 要 】

The Scale-Up project introduced vaginal self-sampling and low-cost human papillomavirus (HPV) testing as the primary approach for cervical cancer screening in selected public health centers in Guatemala, Honduras, and Nicaragua. We evaluate the country-specific accomplishments in screening: target-coverage, triage, and treatment. Between 2015 and 2018, cervical cancer screening was offered to women at least 30 years of age. Triage of HPV-positive women was based on visual inspection with acetic acid or Pap. Aggregated data included total women screened, use of self-sampling, age, time elapsed since last screening, HPV results, triage tests, triage results, and treatment. A total of 231,741 women were screened for HPV, representing 85.8% of the target populations within the project. HPV positivity was lower in Guatemala (12.4%) compared to Honduras and Nicaragua (14.5% and 14.2%, respectively, p < 0.05). A follow-up triage test was completed for 84.2%, 85.8%, and 50.1% of HPV-positive women in Guatemala, Nicaragua, and Honduras, respectively. Of those with a positive triage test, 84.7%, 67.1%, and 58.8% were treated in Guatemala, Nicaragua, and Honduras, respectively. First-time screening was highest in Nicaragua (55.8%) where self-sampling was also widely used (97.1%). The Scale-Up project demonstrated that large-scale cervical cancer screening and treatment intervention in a high-burden, low-resource setting can be achieved. Self-sampling and ablative treatment were key to the project's achievements. Data monitoring, loss to follow-up, and triage methods of screen-positive women remain critical to full success.

【 授权许可】

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