Di Stefano F, Giorgi Rossi P, Carozzi F, Ronco G, Cacciani L, Vecchi S, Naldoni C, Segnan N; Gruppo di lavoro MIDDIR – HPV test in primary screening

Epidemiol Prev. 2017 Jan-Feb;41(2):116-124. doi: 10.19191/EP17.2.P116.031.

Abstract

OBJECTIVES
To obtain data on conversion paths to HPV testing as part of screening programmes and to harmonize the introduction of HPV testing in primary cervical cancer screening protocols of Italian programmes.

DESIGN
Survey by questionnaire on strategies adopted by screening programmes for transition to primary HPV testing; systematic review of the literature; discussion among experts.

SETTING AND PARTICIPANTS: managers of Italian Regions' cervical cancer screening programmes.

MAIN OUTCOME MEASURES
Transition planning; activity volumes; modalities of centralization; criteria for dismissal; staff training; communication initiatives.

RESULTS
Nine cervical screening programmes responded to the survey. Most of them chose to schedule a transition of a few years to allow for adjustment of the volume of activity in the passage from the three-year screening interval to the five-year one. To select women to be given precedence, 7 programmes use the age, starting from the oldest. The liquid base is the choice by far preferred both for HPV test and for Pap test. The reading of HPV test "born" already centralized, but a centralization process is in place also for cytology.

CONCLUSIONS
The survey on conversion strategies to primary HPV testing showed the opportunity to schedule a transition phase. For HPV test, cost, organization, and quality benefits of centralization are clear, thus the central organization should be preferred and managed immediately. Moreover, the need for a centralization of cytology is evident. The tariff scheme should be based on the whole process rather than on single performances. Dismissal strategies have to be tailored on peculiarities of single services, but some typologies can be outlined.

Pubmed: https://www.ncbi.nlm.nih.gov/pubmed/28627153