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Introducing a High-Risk HPV DNA Test Into a Public Sector Screening Program in El Salvador

OBJECTIVE: In a primary human papillomavirus (HPV) screening program, we compared the 6-month follow-up among colposcopy and noncolposcopy-based management strategies for screen-positive women. MATERIALS AND METHODS: Women aged 30 to 49 years were screened with HPV DNA tests using both self-collecti...

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Autores principales: Cremer, Miriam L., Maza, Mauricio, Alfaro, Karla M., Kim, Jane J., Ditzian, Lauren R., Villalta, Sofia, Alonzo, Todd A., Felix, Juan C., Castle, Philip E., Gage, Julia C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819528/
https://www.ncbi.nlm.nih.gov/pubmed/26890683
http://dx.doi.org/10.1097/LGT.0000000000000188
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author Cremer, Miriam L.
Maza, Mauricio
Alfaro, Karla M.
Kim, Jane J.
Ditzian, Lauren R.
Villalta, Sofia
Alonzo, Todd A.
Felix, Juan C.
Castle, Philip E.
Gage, Julia C.
author_facet Cremer, Miriam L.
Maza, Mauricio
Alfaro, Karla M.
Kim, Jane J.
Ditzian, Lauren R.
Villalta, Sofia
Alonzo, Todd A.
Felix, Juan C.
Castle, Philip E.
Gage, Julia C.
author_sort Cremer, Miriam L.
collection PubMed
description OBJECTIVE: In a primary human papillomavirus (HPV) screening program, we compared the 6-month follow-up among colposcopy and noncolposcopy-based management strategies for screen-positive women. MATERIALS AND METHODS: Women aged 30 to 49 years were screened with HPV DNA tests using both self-collection and provider collection of samples. Women testing positive received either (1) colposcopy management (CM) consisting of colposcopy and management per local guidelines or (2) screen-and-treat (ST) management using visual inspection with acetic acid to determine cryotherapy eligibility, with eligible women undergoing immediate cryotherapy. One thousand women were recruited in each cohort. Of these, 368 (18.4%) of 2000 women were recruited using a more intensive outreach strategy. Demographics, HPV positivity, and treatment compliance were compared across recruitment and management strategies. RESULTS: More women in the ST cohort received treatment within 6 months compared with those in the CM cohort (117/119 [98.3%] vs 64/93 [68.8%]; p < .001). Women recruited through more intensive outreach were more likely to be HPV positive, lived in urban areas, were more educated, and had higher numbers of lifetime sexual partners and fewer children. CONCLUSIONS: Women in the CM arm were less likely to complete care than women in the ST arm. Targeted outreach to underscreened women successfully identified women with higher prevalence of HPV and possibly higher disease burden.
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spelling pubmed-48195282016-04-21 Introducing a High-Risk HPV DNA Test Into a Public Sector Screening Program in El Salvador Cremer, Miriam L. Maza, Mauricio Alfaro, Karla M. Kim, Jane J. Ditzian, Lauren R. Villalta, Sofia Alonzo, Todd A. Felix, Juan C. Castle, Philip E. Gage, Julia C. J Low Genit Tract Dis Original Research Articles: Cervix and HPV OBJECTIVE: In a primary human papillomavirus (HPV) screening program, we compared the 6-month follow-up among colposcopy and noncolposcopy-based management strategies for screen-positive women. MATERIALS AND METHODS: Women aged 30 to 49 years were screened with HPV DNA tests using both self-collection and provider collection of samples. Women testing positive received either (1) colposcopy management (CM) consisting of colposcopy and management per local guidelines or (2) screen-and-treat (ST) management using visual inspection with acetic acid to determine cryotherapy eligibility, with eligible women undergoing immediate cryotherapy. One thousand women were recruited in each cohort. Of these, 368 (18.4%) of 2000 women were recruited using a more intensive outreach strategy. Demographics, HPV positivity, and treatment compliance were compared across recruitment and management strategies. RESULTS: More women in the ST cohort received treatment within 6 months compared with those in the CM cohort (117/119 [98.3%] vs 64/93 [68.8%]; p < .001). Women recruited through more intensive outreach were more likely to be HPV positive, lived in urban areas, were more educated, and had higher numbers of lifetime sexual partners and fewer children. CONCLUSIONS: Women in the CM arm were less likely to complete care than women in the ST arm. Targeted outreach to underscreened women successfully identified women with higher prevalence of HPV and possibly higher disease burden. Lippincott Williams & Wilkins 2016-04 2016-03-25 /pmc/articles/PMC4819528/ /pubmed/26890683 http://dx.doi.org/10.1097/LGT.0000000000000188 Text en Copyright © 2016, American Society for Colposcopy and Cervical Pathology This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
spellingShingle Original Research Articles: Cervix and HPV
Cremer, Miriam L.
Maza, Mauricio
Alfaro, Karla M.
Kim, Jane J.
Ditzian, Lauren R.
Villalta, Sofia
Alonzo, Todd A.
Felix, Juan C.
Castle, Philip E.
Gage, Julia C.
Introducing a High-Risk HPV DNA Test Into a Public Sector Screening Program in El Salvador
title Introducing a High-Risk HPV DNA Test Into a Public Sector Screening Program in El Salvador
title_full Introducing a High-Risk HPV DNA Test Into a Public Sector Screening Program in El Salvador
title_fullStr Introducing a High-Risk HPV DNA Test Into a Public Sector Screening Program in El Salvador
title_full_unstemmed Introducing a High-Risk HPV DNA Test Into a Public Sector Screening Program in El Salvador
title_short Introducing a High-Risk HPV DNA Test Into a Public Sector Screening Program in El Salvador
title_sort introducing a high-risk hpv dna test into a public sector screening program in el salvador
topic Original Research Articles: Cervix and HPV
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819528/
https://www.ncbi.nlm.nih.gov/pubmed/26890683
http://dx.doi.org/10.1097/LGT.0000000000000188
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