Cargando…

Scale-Up of an Human Papillomavirus Testing Implementation Program in El Salvador

OBJECTIVE: The Cervical Cancer Prevention in El Salvador is a demonstration project to introduce a lower-cost human papillomavirus (HPV)-DNA test into a public sector project. Started in October 2012, The Cervical Cancer Prevention in El Salvador consists of 3 phases and will ultimately screen 30,00...

Descripción completa

Detalles Bibliográficos
Autores principales: Cremer, Miriam, Maza, Mauricio, Alfaro, Karla, Morales Velado, Mario, Felix, Juan, Castle, Philip E., Kim, Jane, Gage, Julia C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5201413/
https://www.ncbi.nlm.nih.gov/pubmed/27922905
http://dx.doi.org/10.1097/LGT.0000000000000280
_version_ 1782489343850446848
author Cremer, Miriam
Maza, Mauricio
Alfaro, Karla
Morales Velado, Mario
Felix, Juan
Castle, Philip E.
Kim, Jane
Gage, Julia C.
author_facet Cremer, Miriam
Maza, Mauricio
Alfaro, Karla
Morales Velado, Mario
Felix, Juan
Castle, Philip E.
Kim, Jane
Gage, Julia C.
author_sort Cremer, Miriam
collection PubMed
description OBJECTIVE: The Cervical Cancer Prevention in El Salvador is a demonstration project to introduce a lower-cost human papillomavirus (HPV)-DNA test into a public sector project. Started in October 2012, The Cervical Cancer Prevention in El Salvador consists of 3 phases and will ultimately screen 30,000 women. Results of phase 2 of the project are presented. The objective of this project was to compare colposcopy and noncolposcopy-based management for HPV-positive women. MATERIAL AND METHODS: In phase 2, a total of 8,050 women, aged 30 to 49 years, were screened; 6,761 provided both self- and provider-collected specimens and 1,289 provided only provider-testing specimens. HPV results from self-collected specimens were not used in clinical management decisions. Women with provider-collected HPV-positive results were treated based on the strategy assigned to their community; the strategy was colposcopy management (CM) or screen-and-treat (ST) management if they were cryotherapy eligible or colposcopy if not eligible. Outcomes were assessed 6 months after screening. RESULTS: Overall, 489 (12.3%) of 3,963 women receiving CM and 465 (11.4%) of 4,087 women receiving ST tested HPV positive. In the CM cohort, 216 (44.2%) of 489 completed their intervention (203 treated, 11 diagnosed negative, 2 pregnant). In the ST cohort, 411 (88.4%) of 465 completed their intervention (407 treated, 2 diagnosed negative, 1 pregnant). Overall agreement between HPV test results from self-collected and provider-collected specimens was 93.7%, with a κ value of 0.70 (95% CI = 0.68–0.73). CONCLUSIONS: Human papillomavirus testing with ST management resulted in an approximately twice completion rate compared with CM management. Agreement between self- and provider-based sampling was good and might be used to extend screening to women in areas that are more difficult to reach.
format Online
Article
Text
id pubmed-5201413
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-52014132017-01-17 Scale-Up of an Human Papillomavirus Testing Implementation Program in El Salvador Cremer, Miriam Maza, Mauricio Alfaro, Karla Morales Velado, Mario Felix, Juan Castle, Philip E. Kim, Jane Gage, Julia C. J Low Genit Tract Dis Original Research Articles: Cervix and HPV OBJECTIVE: The Cervical Cancer Prevention in El Salvador is a demonstration project to introduce a lower-cost human papillomavirus (HPV)-DNA test into a public sector project. Started in October 2012, The Cervical Cancer Prevention in El Salvador consists of 3 phases and will ultimately screen 30,000 women. Results of phase 2 of the project are presented. The objective of this project was to compare colposcopy and noncolposcopy-based management for HPV-positive women. MATERIAL AND METHODS: In phase 2, a total of 8,050 women, aged 30 to 49 years, were screened; 6,761 provided both self- and provider-collected specimens and 1,289 provided only provider-testing specimens. HPV results from self-collected specimens were not used in clinical management decisions. Women with provider-collected HPV-positive results were treated based on the strategy assigned to their community; the strategy was colposcopy management (CM) or screen-and-treat (ST) management if they were cryotherapy eligible or colposcopy if not eligible. Outcomes were assessed 6 months after screening. RESULTS: Overall, 489 (12.3%) of 3,963 women receiving CM and 465 (11.4%) of 4,087 women receiving ST tested HPV positive. In the CM cohort, 216 (44.2%) of 489 completed their intervention (203 treated, 11 diagnosed negative, 2 pregnant). In the ST cohort, 411 (88.4%) of 465 completed their intervention (407 treated, 2 diagnosed negative, 1 pregnant). Overall agreement between HPV test results from self-collected and provider-collected specimens was 93.7%, with a κ value of 0.70 (95% CI = 0.68–0.73). CONCLUSIONS: Human papillomavirus testing with ST management resulted in an approximately twice completion rate compared with CM management. Agreement between self- and provider-based sampling was good and might be used to extend screening to women in areas that are more difficult to reach. Lippincott Williams & Wilkins 2017-01 2016-12-23 /pmc/articles/PMC5201413/ /pubmed/27922905 http://dx.doi.org/10.1097/LGT.0000000000000280 Text en © 2016, American Society for Colposcopy and Cervical Pathology
spellingShingle Original Research Articles: Cervix and HPV
Cremer, Miriam
Maza, Mauricio
Alfaro, Karla
Morales Velado, Mario
Felix, Juan
Castle, Philip E.
Kim, Jane
Gage, Julia C.
Scale-Up of an Human Papillomavirus Testing Implementation Program in El Salvador
title Scale-Up of an Human Papillomavirus Testing Implementation Program in El Salvador
title_full Scale-Up of an Human Papillomavirus Testing Implementation Program in El Salvador
title_fullStr Scale-Up of an Human Papillomavirus Testing Implementation Program in El Salvador
title_full_unstemmed Scale-Up of an Human Papillomavirus Testing Implementation Program in El Salvador
title_short Scale-Up of an Human Papillomavirus Testing Implementation Program in El Salvador
title_sort scale-up of an human papillomavirus testing implementation program in el salvador
topic Original Research Articles: Cervix and HPV
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5201413/
https://www.ncbi.nlm.nih.gov/pubmed/27922905
http://dx.doi.org/10.1097/LGT.0000000000000280
work_keys_str_mv AT cremermiriam scaleupofanhumanpapillomavirustestingimplementationprograminelsalvador
AT mazamauricio scaleupofanhumanpapillomavirustestingimplementationprograminelsalvador
AT alfarokarla scaleupofanhumanpapillomavirustestingimplementationprograminelsalvador
AT moralesveladomario scaleupofanhumanpapillomavirustestingimplementationprograminelsalvador
AT felixjuan scaleupofanhumanpapillomavirustestingimplementationprograminelsalvador
AT castlephilipe scaleupofanhumanpapillomavirustestingimplementationprograminelsalvador
AT kimjane scaleupofanhumanpapillomavirustestingimplementationprograminelsalvador
AT gagejuliac scaleupofanhumanpapillomavirustestingimplementationprograminelsalvador