Evaluation of the self-sampling for cervical cancer screening in Bolivia

Allende, Gustavo; Surriabre, Pedro; Cáceres, Leyddy; Bellot, Diego; Ovando, Neli; Torrico, Andrea; Calle, Pamela; Ascarrunz, Carla; Alexander, Sophie; Bossens, Michel; Fontaine, Véronique; Rodríguez, Patricia

doi:10.1186/s12889-019-6401-5

Cited by 26 publications

(46 citation statements)

References 25 publications

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“…It is worth noting that the HR-HPV test was robust, giving results with no inter-observer variation [16]. The main advantage of this screening method is that it allows reaching women from rural areas or women rejecting the gynecological revision [7,12,15,24]. As the VIA test, the HPV test had a low positive predictive value (18%) requesting an additional triage methodology, as previously reported [25][26][27][28][29].…”

Section: Discussionmentioning

confidence: 72%

“…Since our self-sampled HR-HPV detection test (HPV screening) could overcome sociocultural barriers and to increase screening coverage [12], an also showed an acceptable sensitivity and negative predictive value, we propose that it could be combined with a triage method, like the VIA (i.e. in a see and treat strategy), considering the complementary high specificity and the possibility to give immediate results with the VIA, to eventually immediately allow for CIN2+ lesion treatment by cryotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…The situation in Bolivia is alarming regarding the incidence and mortality rates of uterine cervix cancer, with the highest incidence in America (38 per 100,000 women) and a mortality rate of 19 per 100,000 women (rates standardized by age) [10]. The main reasons to inadequate prevention of cervical cancer in Bolivia are the low screening coverage of the Papanicolaou smear cytology test (Pap smear), the lack of follow up of the positive cases, the poor information given on cervical cancer prevention, the deficient training of the health staff, the low credibility in the public health system and finally economic, geographic and sociocultural barriers reducing the access of the Bolivian to health care centers [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…To improve this situation, our group has recently evaluated the acceptability of introducing an HR-HPV test on self-collected samples with cheap and simple devices [12,15]. Indeed, we have previously shown the analytical performance of the HR-HPV detection on samples selfcollected with a cotton swab, dried before transport on glass slide [15].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the effectiveness of high-risk human papilloma self-sampling test for cervical cancer screening in Bolivia

et al. 2020

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Background: In Bolivia the incidence and mortality rates of uterine cervix cancer are the highest in America. The main factor contributing to this situation is the difficulty of establishing and maintaining quality prevention programs based on cytology. We aimed to evaluate the effectiveness of HR-HPV testing on self-collected samples to detect cervical intra-epithelial neoplasia and identify the best combination of screening tests. Methods: A total of 469 women, divided in two groups, were included in this study. The first group included 362 women that underwent three consecutively primary screening tests: self-collected sampling for HR-HPV detection, conventional cervical cytology and visual inspection under acetic acid (VIA). The second group included 107 women referred with a positive HR-HPV test that underwent conventional cervical cytology and VIA. The presence of high grade intraepithelial lesion (CIN 2+) or invasive cancer was verified by colposcopy and biopsy. Result: In the screening group the sensitivity to detect high grade intraepithelial lesion (CIN 2+) or invasive cancer were 100, 76, 44% for the VIA, HR-HPV test and cytology, respectively. In the referred group, the sensitivity to detect high grade intraepithelial lesion (CIN 2+) or invasive cancer by VIA and cytology were 100 and 81%, respectively. Conclusions: VIA and HR-HPV self-sampling were the best combination to detect CIN2+ lesions. Cytology analysis gave the poorest performance.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the effectiveness of high-risk human papilloma self-sampling test for cervical cancer screening in Bolivia

et al. 2020

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“…Purified DNA from DCCS were assessed by a Taqman real-time PCR assay which identifies 12 high-risk (16,18,31,33,35,39,45…”

Section: Hpv Typingmentioning

confidence: 99%

Prevalence of viral sexually transmitted infections and HPV high-risk genotypes in women in rural communities in the Department of La Paz, Bolivia

Patzi-Churqui

Terrazas-Aranda

Liljeqvist

et al. 2020

Preprint

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Background: Bolivia has the highest prevalence of cervical cancer in South America and the prevalence of viral sexually transmitted infections (STIs) among people in urban cities is increasing. Little is known about the prevalence of viral STIs in rural communities, which generally have limited access to health care. In order to study the prevalence of viral STIs in rural Bolivia, we recruited women from villages and towns in the Department of La Paz in Bolivia. Methods: 394 female participants were assessed for IgG-antibodies to herpes simplex virus type 2 (HSV-2), human immunodeficiency virus (HIV) and hepatitis B virus (HBV, anti-HBc), as well as for the presence of HBV surface antigen (HBsAg) in dried blood spots. The prevalence of 12 high-risk types of human papillomavirus (HPV) was assessed by qPCR in dried cervicovaginal cell spots from 376 of these women. χ 2 test was used to compare variables between the populations and binary logistic regression was used to identify risk factors associated with the positivity of the tests. Results: The seroprevalence of HSV-2 was 53% and of HBV 10.3%. HBAg was detected in 15.8% of women with anti-HBV antibodies indicating chronic infection. The frequency of high-risk HPV infection was 27%, with the most prevalent high-risk HPV types being HPV 56, 39 and 31 followed by HPV 16 and 18. Finally, none of the 394 women were seropositive for HIV, and about 64% of the studied population was positive for at least one of the viral infections. Conclusions: Women in Bolivian rural communities in La Paz show a high prevalence of HBV, HPV and, in particular, HSV-2. In contrast, none of the women were HIV positive, suggesting that the HIV prevalence in this population is low. The pattern of high-risk HPV types differed from many other countries with a predominance of HPV-types not included in the Gardasil vaccine which was officially introduced in Bolivia in April 2017. Key words : Prevalence, Sexually transmitted infections, women, La Paz, Bolivia, rural communities, HSV-2, HIV, high-risk HPV, HBV.

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Factors Influencing the Cost-Effectiveness Outcomes of HPV Vaccination and Screening Interventions in Low-to-Middle-Income Countries (LMICs): A Systematic Review

Okeah

Ridyard

2020

Appl Health Econ Health Policy

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Background: Cervical cancer ranks fourth amongst the commonest malignancies worldwide and the second most prevalent cancer afflicting women in low-to middle-income countries (LMICs), hence, of great public health importance. LMICs are the most affected regions as evidenced by their high prevalence of the disease. Mortality associated with cervical neoplasms is preventable through the implementation of recommended preventive approaches.Aims: This review aimed at appraising evidence on the cost-effectiveness of cervical cancer prevention interventions in LMICs involving cervical screening and HPV vaccination programmes.Methods: A search of CINAHL, MEDLINE, PubMed, and Web of Science was elicited and studies published between 1 st January 2008 and 31 st December 2018 were retrieved. Two authors independently undertook the screening, review, selection of studies, and data extraction with disagreements being resolved through discussion and consensus.Results: Twelve studies were selected. The cost-effectiveness outcomes of HPV vaccination and screening interventions are dependent on age, screening method used, intervention coverage, and the number of doses or visits required for vaccination and screening respectively. A combination of visual inspection with acetic acid (VIA) screening and HPV vaccination appears to be the most cost-effective approach in reducing the lifetime risk for HPV-linked cervical neoplasms. Similarly, vaccination as a stand-alone intervention is potentially cost effective provided the coverage is maintained between 70-100%.Conclusions: HPV vaccination and screening interventions may be cost-effective in LMICs and potentially reduce the lifetime risk, economic burden, and associated mortality. However, it is important to consider the factors that influence the cost-effectiveness of cervical cancer prevention interventions for better outcomes to be realised. Key points for decision makers▪ HPV vaccination and VIA screening appear to be cost-effective approaches for reducing the lifetime risks for cervical cancer in LMICs ▪ A high loss-to-follow-up for vaccination and screening is associated with increased mortality ▪ Early screening for HPV below the age of 30 years could potentially reduce cervical cancer associated morbidity and mortality ▪ Implementation of organised programmes improves coverage and has better outcomes compared to opportunistic programmes

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Evaluation of the self-sampling for cervical cancer screening in Bolivia

Cited by 26 publications

References 25 publications

Evaluation of the effectiveness of high-risk human papilloma self-sampling test for cervical cancer screening in Bolivia

Evaluation of the effectiveness of high-risk human papilloma self-sampling test for cervical cancer screening in Bolivia

Prevalence of viral sexually transmitted infections and HPV high-risk genotypes in women in rural communities in the Department of La Paz, Bolivia

Factors Influencing the Cost-Effectiveness Outcomes of HPV Vaccination and Screening Interventions in Low-to-Middle-Income Countries (LMICs): A Systematic Review

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