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Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study
BACKGROUND: Replacement of cytology screening with HPV testing is recommended and essential for cervical cancer elimination. HPV testing for primary screening was implemented in 12 laboratories within 9 Latin American countries, as part of the ESTAMPA cervical cancer screening study. Our observation...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714610/ https://www.ncbi.nlm.nih.gov/pubmed/36465901 http://dx.doi.org/10.3389/fmed.2022.1006038 |
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author | Rol, Mary Luz Picconi, María Alejandra Ferrera, Annabelle Sánchez, Gloria Inés Hernández, María de la Luz Lineros, Joana Peraza, Ana Brizuela, Marisol Mendoza, Laura Mongelós, Pamela Cabrera, Yessy Rodríguez de la Peña, Margarita Correa, Rita Mariel Terán, Carolina Colque Reynaga, Deisy García, Laura Ramírez, Arianis Tatiana Hernández-Nevarez, Pilar Doimi, Franco Ramón, María Arias-Stella, Javier Zúñiga, Michael Villagra, Verónica Bobadilla, María Liz Cardinal, Lucía Valls, Joan Lucas, Eric Baena, Armando Fleider, Laura Venegas, Gino Cruz-Valdez, Aurelio Rodríguez, Guillermo Calderón, Alejandro Wiesner, Carolina Luciani, Silvana Broutet, Nathalie Herrero, Rolando Almonte, Maribel |
author_facet | Rol, Mary Luz Picconi, María Alejandra Ferrera, Annabelle Sánchez, Gloria Inés Hernández, María de la Luz Lineros, Joana Peraza, Ana Brizuela, Marisol Mendoza, Laura Mongelós, Pamela Cabrera, Yessy Rodríguez de la Peña, Margarita Correa, Rita Mariel Terán, Carolina Colque Reynaga, Deisy García, Laura Ramírez, Arianis Tatiana Hernández-Nevarez, Pilar Doimi, Franco Ramón, María Arias-Stella, Javier Zúñiga, Michael Villagra, Verónica Bobadilla, María Liz Cardinal, Lucía Valls, Joan Lucas, Eric Baena, Armando Fleider, Laura Venegas, Gino Cruz-Valdez, Aurelio Rodríguez, Guillermo Calderón, Alejandro Wiesner, Carolina Luciani, Silvana Broutet, Nathalie Herrero, Rolando Almonte, Maribel |
author_sort | Rol, Mary Luz |
collection | PubMed |
description | BACKGROUND: Replacement of cytology screening with HPV testing is recommended and essential for cervical cancer elimination. HPV testing for primary screening was implemented in 12 laboratories within 9 Latin American countries, as part of the ESTAMPA cervical cancer screening study. Our observations provide information on critical operational aspects for HPV testing implementation in diverse resource settings. METHODS: We describe the implementation process of HPV testing in ESTAMPA, focusing on laboratory aspects. We assess the readiness of 12 laboratories to start HPV testing and their continuity capacity to maintain good quality HPV testing until end of recruitment or up to December 2021. Readiness was based on a checklist. Information from the study database; regular meetings and monitoring visits; and a questionnaire on laboratory operational aspects sent in May 2020 were used to assess continuity capacity. Compliance with seven basic requirements (readiness) and eight continuity requirements (continuity capacity) was scored (1 = compliant, 0 = not compliant) and totaled to classify readiness and continuity capacity as very limited, limited, moderate or high. Experiences, challenges, and enablers of the implementation process are also described. RESULTS: Seven of 12 laboratories had high readiness, three moderate readiness, and of two laboratories new to HPV testing, one had limited readiness and the other very limited readiness. Two of seven laboratories with high readiness also showed high continuity capacity, one moderate continuity capacity, and the other four showed limited continuity capacity since they could not maintain good quality HPV testing over time. Among three laboratories with moderate readiness, one kept moderate continuity capacity and two reached high continuity capacity. The two laboratories new to HPV testing achieved high continuity capacity. Based on gained expertise, five laboratories have become part of national screening programs. CONCLUSION: High readiness of laboratories is an essential part of effective implementation of HPV testing. However, high readiness is insufficient to guarantee HPV testing high continuity capacity, for which a “culture of quality” should be established with regular training, robust monitoring and quality assurance systems tailored to local context. All efforts to strengthen HPV laboratories are valuable and crucial to guarantee effective implementation of HPV-based cervical screening. |
format | Online Article Text |
id | pubmed-9714610 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97146102022-12-02 Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study Rol, Mary Luz Picconi, María Alejandra Ferrera, Annabelle Sánchez, Gloria Inés Hernández, María de la Luz Lineros, Joana Peraza, Ana Brizuela, Marisol Mendoza, Laura Mongelós, Pamela Cabrera, Yessy Rodríguez de la Peña, Margarita Correa, Rita Mariel Terán, Carolina Colque Reynaga, Deisy García, Laura Ramírez, Arianis Tatiana Hernández-Nevarez, Pilar Doimi, Franco Ramón, María Arias-Stella, Javier Zúñiga, Michael Villagra, Verónica Bobadilla, María Liz Cardinal, Lucía Valls, Joan Lucas, Eric Baena, Armando Fleider, Laura Venegas, Gino Cruz-Valdez, Aurelio Rodríguez, Guillermo Calderón, Alejandro Wiesner, Carolina Luciani, Silvana Broutet, Nathalie Herrero, Rolando Almonte, Maribel Front Med (Lausanne) Medicine BACKGROUND: Replacement of cytology screening with HPV testing is recommended and essential for cervical cancer elimination. HPV testing for primary screening was implemented in 12 laboratories within 9 Latin American countries, as part of the ESTAMPA cervical cancer screening study. Our observations provide information on critical operational aspects for HPV testing implementation in diverse resource settings. METHODS: We describe the implementation process of HPV testing in ESTAMPA, focusing on laboratory aspects. We assess the readiness of 12 laboratories to start HPV testing and their continuity capacity to maintain good quality HPV testing until end of recruitment or up to December 2021. Readiness was based on a checklist. Information from the study database; regular meetings and monitoring visits; and a questionnaire on laboratory operational aspects sent in May 2020 were used to assess continuity capacity. Compliance with seven basic requirements (readiness) and eight continuity requirements (continuity capacity) was scored (1 = compliant, 0 = not compliant) and totaled to classify readiness and continuity capacity as very limited, limited, moderate or high. Experiences, challenges, and enablers of the implementation process are also described. RESULTS: Seven of 12 laboratories had high readiness, three moderate readiness, and of two laboratories new to HPV testing, one had limited readiness and the other very limited readiness. Two of seven laboratories with high readiness also showed high continuity capacity, one moderate continuity capacity, and the other four showed limited continuity capacity since they could not maintain good quality HPV testing over time. Among three laboratories with moderate readiness, one kept moderate continuity capacity and two reached high continuity capacity. The two laboratories new to HPV testing achieved high continuity capacity. Based on gained expertise, five laboratories have become part of national screening programs. CONCLUSION: High readiness of laboratories is an essential part of effective implementation of HPV testing. However, high readiness is insufficient to guarantee HPV testing high continuity capacity, for which a “culture of quality” should be established with regular training, robust monitoring and quality assurance systems tailored to local context. All efforts to strengthen HPV laboratories are valuable and crucial to guarantee effective implementation of HPV-based cervical screening. Frontiers Media S.A. 2022-11-17 /pmc/articles/PMC9714610/ /pubmed/36465901 http://dx.doi.org/10.3389/fmed.2022.1006038 Text en Copyright © 2022 Rol, Picconi, Ferrera, Sánchez, Hernández, Lineros, Peraza, Brizuela, Mendoza, Mongelós, Cabrera, Rodríguez de la Peña, Correa, Terán, Colque Reynaga, García, Ramírez, Hernández-Nevarez, Doimi, Ramón, Arias-Stella, Zúñiga, Villagra, Bobadilla, Cardinal, Valls, Lucas, Baena, Fleider, Venegas, Cruz-Valdez, Rodríguez, Calderón, Wiesner, Luciani, Broutet, Herrero and Almonte. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Rol, Mary Luz Picconi, María Alejandra Ferrera, Annabelle Sánchez, Gloria Inés Hernández, María de la Luz Lineros, Joana Peraza, Ana Brizuela, Marisol Mendoza, Laura Mongelós, Pamela Cabrera, Yessy Rodríguez de la Peña, Margarita Correa, Rita Mariel Terán, Carolina Colque Reynaga, Deisy García, Laura Ramírez, Arianis Tatiana Hernández-Nevarez, Pilar Doimi, Franco Ramón, María Arias-Stella, Javier Zúñiga, Michael Villagra, Verónica Bobadilla, María Liz Cardinal, Lucía Valls, Joan Lucas, Eric Baena, Armando Fleider, Laura Venegas, Gino Cruz-Valdez, Aurelio Rodríguez, Guillermo Calderón, Alejandro Wiesner, Carolina Luciani, Silvana Broutet, Nathalie Herrero, Rolando Almonte, Maribel Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study |
title | Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study |
title_full | Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study |
title_fullStr | Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study |
title_full_unstemmed | Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study |
title_short | Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study |
title_sort | implementing hpv testing in 9 latin american countries: the laboratory perspective as observed in the estampa study |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714610/ https://www.ncbi.nlm.nih.gov/pubmed/36465901 http://dx.doi.org/10.3389/fmed.2022.1006038 |
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