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Introduction of HPV testing for cervical cancer screening in Central America: The Scale-Up project.
Holme, Francesca; Jeronimo, Jose; Maldonado, Francisco; Camel, Claudia; Sandoval, Manuel; Martinez-Granera, Benito; Montenegro, Mirna; Figueroa, Jacqueline; Slavkovsky, Rose; Thomson, Kerry A; de Sanjose, Silvia.
Affiliation
  • Holme F; PATH, Seattle, WA, USA. Electronic address: fholme@path.org.
  • Jeronimo J; José Jeronimo Consulting, Damascus, MD, USA.
  • Maldonado F; Movicáncer, Managua, Nicaragua. Electronic address: francisco.maldonado@movicancer.org.ni.
  • Camel C; Ministry of Public Health and Social Assistance, Guatemala City, Guatemala.
  • Sandoval M; Asociación Hondureña de Planificación de Familia, Tegucigalpa, Honduras. Electronic address: MSandoval@ashonplafa.org.
  • Martinez-Granera B; Movicáncer, Managua, Nicaragua. Electronic address: orlando.granera@movicancer.org.ni.
  • Montenegro M; Instancia por la Salud y el Desarrollo de las Mujeres, Guatemala City, Guatemala.
  • Figueroa J; Secretary of Health, Tegucigalpa, Honduras. Electronic address: jacquelinefigueroa@salud.gob.hn.
  • Slavkovsky R; PATH, Seattle, WA, USA. Electronic address: rslavkovsy@path.org.
  • Thomson KA; PATH, Seattle, WA, USA. Electronic address: kthomson@path.org.
  • de Sanjose S; PATH, Seattle, WA, USA. Electronic address: sdesanjose@path.org.
Prev Med ; 135: 106076, 2020 06.
Article de En | MEDLINE | ID: mdl-32247010
ABSTRACT
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.
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Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Tumeurs du col de l&apos;utérus / Triage / Infections à papillomavirus / Dépistage précoce du cancer Type d'étude: Diagnostic_studies / Screening_studies Limites: Adult / Female / Humans / Middle aged Pays/Région comme sujet: America central Langue: En Journal: Prev Med Année: 2020 Type de document: Article

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Tumeurs du col de l&apos;utérus / Triage / Infections à papillomavirus / Dépistage précoce du cancer Type d'étude: Diagnostic_studies / Screening_studies Limites: Adult / Female / Humans / Middle aged Pays/Région comme sujet: America central Langue: En Journal: Prev Med Année: 2020 Type de document: Article