HPV testing in Polish population-based cervical cancer screening programme (HIPPO project)-study protocol of a randomised healthcare policy trial.

BACKGROUND: An Organised Cervical Cancer Screening Programme (OCCSP) was started in Poland in 2006/2007. Each woman aged 25 to 59 is eligible for a free Pap test every 3 years in OCCSP. Despite implementation of the OCCSP, the age-standardised cervical cancer (CC) incidence and mortality rates in 2019 were 7.3/100 000 and 3.9/100 000 respectively and were still higher than those in Western European countries with well-organised screening programmes. Apart from low coverage of the OCCSP, suboptimal performance of the screening test (conventional cytology) may be partially responsible for this situation. Several countries have already incorporated high risk Human Papillomavirus (hrHPV) testing in CC screening as a more sensitive tool reducing the risk of missing precancerous lesions and allowing for extension of screening intervals. The European Guidelines for Quality Assurance in Cervical Cancer Screening recommend pilot evaluation of a new screening test in country-specific conditions before its implementation. METHODS: The HIPPO project (HPV testing In Polish POpulation-based cervical cancer screening program) is a randomised health services study nested in the OCCSP in Poland. The project will randomise 33 000 women aged 30-59 years to cytology or hrHPV testing (ratio: 1:1) with age stratification. In the cytology arm women with repeated Atypical Squamous Cells of Undetermined Significance (ASC-US) or ≥ Low-Grade Squamous Intraepithelial Lesions (LSIL) are referred for colposcopy. In the other arm, hrHPV ( +) women with ≥ ASC-US reflex Liquid-Based Cytology (LBC) are referred for colposcopy. Primary endpoints include detection rates of histologically confirmed high grade intraepithelial lesions or worse (CIN2 +) in each arm. DISCUSSION: This pilot randomised healthcare study nested in the OCCSP in Poland will assess and compare the performance of hrHPV testing to current standard-cytology in order to make decisions on implementation of HPV-based screening in the country. TRIAL REGISTRATION: This randomised healthcare service study was prospectively registered at https://clinicaltrials.gov/ (identifier: NCT04111835, protocol ID 28/2019) on 19th of September 2019.

Age-related differences in everyday prospective memory tasks: the role of planning and personal importance.

The aim of the present studies was to investigate whether age-related improvement found in naturalistic but experimenter-given prospective memory (PM) tasks can be generalized to real-life intentions. In Study 1, younger, middle-aged, and older adults generated a list of intended activities for the following week; one week later they marked the tasks that they had performed. The participants were also asked to rate the importance of each listed intention and to describe the circumstances of completion that were already known to them. We found that, compared with younger adults, older adults attributed a higher degree of importance to their intentions and had the circumstances of their completion better planned. However, the age-related benefit in the PM performance for all listed intentions was not present for the very important and well-planned tasks. In Study 2 we manipulated whether younger adults engaged or not in the detailed planning of when their intentions could be completed. It was demonstrated that younger adults who had to perform detailed planning completed their intended activities more often than those who did not plan for their intentions. The results support explanations of the age-related benefit in everyday PM that highlight the role of importance and planning.