Implementation of a centralized HPV-based cervical cancer screening programme in Tuscany: First round results and comparison with the foregoing Pap-based screening programme
| Autor: | Francesca Carozzi, Elena Burroni, Massimo Confortini, Giampaolo Pompeo, Simonetta Bisanzi, Filippo Cellai, Irene Paganini, Paola Mantellini, Anna Iossa, Lisa Lelli, Carmelina Di Pierro, Marzia Matucci, Stefania Cannistrà, Roberta Rosati, Alessandra Mongia, Carmen Beatriz Visioli, Giuseppe Gorini, Cristina Sani, null the Tuscany HPV-based Screening Working Group |
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| Rok vydání: | 2022 |
| Předmět: |
Male
Vaginal Smears Health Policy Papillomavirus Infections Public Health Environmental and Occupational Health Uterine Cervical Neoplasms Uterine Cervical Dysplasia female genital diseases and pregnancy complications Colposcopy Pregnancy Humans Mass Screening Female Papillomaviridae Early Detection of Cancer Aged |
| Zdroj: | Journal of medical screening. 29(2) |
| ISSN: | 1475-5793 |
| Popis: | Objective To evaluate performance of the first round of HPV-based screening in Tuscany region and compare it with the prior round of Pap-based screening Setting Tuscany region of Italy, where HPV-based cervical cancer screening started in 2013, with a strong level of centralization screening tests at the Regional Laboratory for Cancer Prevention (ISPRO). Methods The transition from Pap- to HPV-based screening was initiated for older women and at 3 out of 12 Tuscany Local Health Units (LHUs). Data from the Florence and Grosseto LHUs (about 300,000 women) were analysed and performance screening indicators estimated. Results HPV-based indicators recorded good performance, with increased compliance vs. the Pap-based programme. We registered a substantial decrease in waiting times from sampling to test reporting, probably related to the centralization strategy. Since the screening protocol was the same and conducted at a single laboratory, we could hypothesize that the difference in HPV positivity (6.8% in Florence vs. 8.4% in Grosseto) was due to a real difference in HPV prevalence among women of the two LHUs. The transition to HPV-based screening led to a significant increase both in colposcopy referral rate (4.3% vs. 1.2%) and CIN2+ detection rate (8.3‰ vs. 3.4‰). Conclusions HPV-based is more effective in detecting high-grade precancerous and cancerous lesions than Pap-based screening and is characterized by an “anticipatory effect” in the detection of CIN2+ lesions. The transition from Pap-based to HPV-based screening programme should include increased resources dedicated to colposcopy services. Centralization in a laboratory with long experience in this field promotes efficiency of the screening process. |
| Databáze: | OpenAIRE |
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