Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing

Chrysostomou, Andreas; Stylianou, Dora C.; Constantinidou, Anastasia; Kostrikis, Leondios G.

doi:10.3390/v10120729

Cited by 197 publications

(210 citation statements)

References 310 publications

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“…As per the WHO guidelines, there has been a global shift to HPV-based cervical screening 4. Worldwide, countries including the UK, Ireland, Netherlands and Turkey have implemented national HPV-based cervical screening, with many more transitioning towards primary HPV testing 5 6. Previous international studies stated most women are unaware of the use of primary HPV testing7 and that some women may experience a negative emotional response towards primary HPV testing as it is a sexually transmitted infection 8 9.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and perspectives of the new National Cervical Screening Program: a qualitative interview study of North Queensland women—‘I could be that one percent’

et al. 2020

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ObjectivesTo investigate women’s understanding and attitudes towards the National Cervical Screening Program (NCSP) and to explore methods to improve screening participation.DesignSemi-structured face-to-face interviews were conducted through convenience and snowball sampling. Thematic analysis occurred using the interpretivist framework.SettingA private general practice in North Queensland.ParticipantsWomen between the ages of 18 and 74 who attended the general practice were eligible to participate. Fourteen women between 20 and 58 years old were interviewed.ResultsParticipants were concerned that the new NCSP would miss cancer due to longer screening intervals and reliance on primary human papilloma virus (HPV) testing. They believed that young women are at increased risk of cervical cancer, due to perceived HPV vaccine ineffectiveness and parent objection to vaccination. Most participants were not agreeable to self-sampling and preferred their doctor to perform screening. Personal and practitioner beliefs influenced a woman’s screening participation. Personal factors include being healthy for themselves and their family, previous abnormal smears and family history of cancer. Emphasis was placed on feeling ‘comfortable’ with their practitioner which included patient rapport and gender preference. Proposed methods to improve cervical screening included education programmes, advertising campaigns, general practitioner interventions and improving accessibility.ConclusionsIt is apparent that women are hesitant about the new NCSP. However, when provided with additional information they were more amenable to the changes. This highlights the need to improve awareness of cervical screening and the new NCSP.

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Section: Introductionmentioning

confidence: 99%

Knowledge and perspectives of the new National Cervical Screening Program: a qualitative interview study of North Queensland women—‘I could be that one percent’

et al. 2020

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“…HPV testing alone or co-testing is the main difference between the European and American guidelines: the American guidelines recommend co-testing with HPV and cytology, [ 27 ] while the European guidelines recommend HPV alone. [ 28 ] China has a large population and regional economic distribution. The current cervical cancer screening program in China is implemented in a “3-Step” strategy, including TCT, HPV testing, and colposcopy, and is carried out in a diversified manner, adopting different screening strategies for different groups of people.…”

Section: Discussionmentioning

confidence: 99%

Triage human papillomavirus testing for cytology-based cervical screening in women of different ages in primary hospitals

Zhang

et al. 2020

Medicine

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Cervical cancer is a serious global health problem. The objective of this study was to provide a suitable cytology-based cervical screening method in women of different ages in primary hospitals. This study was a retrospective cohort study that included 9765 women who underwent primary cytology-based cervical screening and were grouped by age (35–44, 45–54, and 55–64 years old). Patients with abnormal cytology on the primary cervical thin-prep cytologic test (TCT) were advised to undergo triage human papillomavirus (HPV) test. Furthermore, patients with positive outcomes of the 2 indices underwent cervical tissue biopsy. The positive rate of TCT and HPV was compared among the 3 defined age groups. The sensitivity, specificity, and positive predictive value of TCT and HPV were assessed. In total, 2.5% (241/9765) of women had atypical squamous cells of undetermined significance or worse by TCT. High-risk (HR)-HPV infection was found in 70 triage participants. Neoplastic changes were confirmed in 95 patients (95/437, 21.7%) by biopsies. Among the different age groups, the positive rate of abnormal cytology was significantly different ( P = .003), and the positive rate of HR-HPV was similar ( P = .299). The sensitivity of initial TCT testing to detect intraepithelial neoplasia was higher than that of triage HPV testing, whereas the specificity, the positive predictive value of triage HPV testing was higher than that of TCT. The Youden index of HPV testing was higher than that of TCT detection in the 3 age groups, namely 0.582 versus 0.432, 0.553 versus 0.228, and 0.416 versus 0.332, respectively. The results of this study indicate that TCT testing is suitable as a cervical cancer screening method for women ≥35 years old in primary hospitals. Triage testing for women with HR-HPV has a high negative predictive value, reduces the rate of misdiagnosis, seems to be an excellent triage method for repeat atypical squamous cells of undetermined significance, and reduces the number of referral colposcopies preventing unnecessary overtreatment. The results of this study provide a crucial foundation for a unified guideline cervical cancer screening for primary health care institutions.

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“…according to the european Guidelines, as well as the world health Organization (whO), hPV testing is now proposed as the primary screening tool for cervical cancer [13,14]. there are several countries in europe and all over the world integrating hPV vaccination and population-based hPV testing in cervical cancer screening programmes [15]. Nevertheless, in Poland, the cervical cancer screening programme is based on the conventional Pap test, repeated every three years among women aged 25-69 [16].…”

Section: Introductionmentioning

confidence: 99%

Knowledge of the role of vaccinations, physical activity and other cancer prevention methods among Polish outpatients

Kurczewska-Michalak¹,

Kardas²

2020

fmpcr

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Background. Mortality rates connected with cancer are increasing nowadays due to demographic changes in the worldwide population and the increasing number of health risks leading to cancer. Primary cancer prevention is based on avoiding exposure to identified cancer risk factors. therefore, awareness of basic health hazards is necessary. Objectives. the purpose of this study was to assess the knowledge of the role of vaccinations, physical activity, secondhand smoke exposure and other factors in cancer prevention in Polish outpatients. Material and methods. this was a survey involving Polish primary care patients. the study was based on an original questionnaire designed for this purpose and was distributed among primary care patients in either hardcopy (among primary care patients in the urban settings of the city of lodz) or over the internet. Results. 612 respondents took part in the study. among the respondents, 28.4% claimed that vaccinations do not play any role in cancer prevention. Physical activity may prevent cancer according to 58.6% of the surveyed population. tobacco smoking is a well-known cancer risk factor, which was admitted to by 97.2% of the respondents. secondhand smoke exposure in the workplace was reported by 18.3% of the respondents, more often by those with secondary education than with a university degree. secondhand smoke exposure was strongly connected with the age of the respondents. Conclusions. there is little knowledge about vaccines and physical activity as cancer prevention methods. tobacco smoking is a well-known cancer risk factor. secondhand smoke exposure remains a serious problem in Poland despite a total ban on smoking in the workplace and public places.

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Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing

Cited by 197 publications

References 310 publications

Knowledge and perspectives of the new National Cervical Screening Program: a qualitative interview study of North Queensland women—‘I could be that one percent’

Knowledge and perspectives of the new National Cervical Screening Program: a qualitative interview study of North Queensland women—‘I could be that one percent’

Triage human papillomavirus testing for cytology-based cervical screening in women of different ages in primary hospitals

Knowledge of the role of vaccinations, physical activity and other cancer prevention methods among Polish outpatients

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