Effectiveness and costs of an implemented primary HPV cervical screening programme in Sweden – A population based cohort study

Bergengren, Lovisa; Ryen, Linda; Flodström, Clelia; Fadl, Helena; Udumyen, Ruzan; Karlsson, Mats G.; Helenius, Gisela

doi:10.1016/j.pmedr.2021.101675

Cited by 8 publications

(7 citation statements)

References 25 publications

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“…Another study predicting the cost-effectiveness of screening with hrHPV testing showed a decrease in the incremental cost-effectiveness ratio (ICER) of (USD −6.16) relative to conventional cervical cytology. Quality-adjusted life-years (QALYs) were 386.98 for cytology and 390.80 for hrHPV-based testing, respectively [ 58 , 59 ]. A combination of LBC and HPV testing methods is called co-testing.…”

Section: Review Resultsmentioning

confidence: 99%

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Cervical Cancer Prophylaxis—State-of-the-Art and Perspectives

Poniewierza¹,

Panek

2022

Healthcare

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Background: Each year 604,127 new cases of cervical cancer (CC) are diagnosed, and 341,831 individuals die from the disease. It is the fourth most common cancer among women and the fourth most common cause of death from female cancers worldwide. The pathogenesis of CC is associated with human papillomavirus (HPV) infections and consists of several steps involving cell proliferation outside the human body’s control mechanisms. Strategies to prevent CC are based on screening and vaccination. Scope of the Review: The aim of this paper was to collect and analyze the available literature on the issue of CC prevention and the impact of the COVID-19 pandemic on its implementation. For this purpose, PubMed and Google Scholar databases were searched using keywords, such as “cervical cancer”; “HPV”; “prevention”; “prophylaxis”; “vaccination”; “screening” and “COVID-19” in different variations. Only articles published since 2018 were included in the study. Conclusions: Selected European countries have different CC prevention programs funded by national budgets. This translates into observed differences in the risk of death from CC (age-standardized rate Malta = 1.1, Poland = 5.9). COVID-19 pandemic due to disruption of CC screening may exacerbate these differences in the future. To improve the situation, new screening methods, such as p16/Ki67, HPV self-testing, and the use of artificial intelligence in colposcopic assessment, should be disseminated, as well as free HPV vaccination programs implemented in all countries. The search for new solutions is not without significance and entails ultra-sensitive screening tests for risk groups (mRNA E6/E7, SOX1/SOX14), HPV vaccines with shorter dosing schedules, and new therapeutic pathways using nanotheranostics.

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Section: Review Resultsmentioning

confidence: 99%

“…The most common type is HPV 16 (50% of cases). Other oncogenic HPV types responsible for persistent cervical tissue infections include HPV 18,31,33,35,39,45,51,52,56,58,59, 66, and 68. However, infection alone is not sufficient for disease development.…”

Section: Introductionmentioning

confidence: 99%

Cervical Cancer Prophylaxis—State-of-the-Art and Perspectives

Poniewierza¹,

Panek

2022

Healthcare

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“…Para que la infección por el VPH, cause lesiones intraepiteliales (LIE) o Ca de cuello uterino, debe existir una cronicidad de la infección, es por ello que, se presenta el contagio por VPH mucho antes de que se presenten las LIE (9). En personas con inmunosupresión, como en el VIH, se ve un aumento de la frecuencia de las LIE del 4,6% en mujeres, del 7,2% en varones y del 18,5% en HSH (10).…”

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Virus del papiloma humano de alto riesgo y factores asociados en mujeres de Ecuador

Torres

Cortez²,

Suárez³

et al. 2022

revistavive

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El cáncer de cérvix en el 99% de los casos, es causado por el Virus del Papiloma Humano (VPH) de alto riesgo, su prevalencia es elevada en países de bajos ingresos debido a la escasez de recursos para realizar programas generalizados de detección precoz, inmunización y tratamiento adecuado. El objetivo de la investigación fue identificar la frecuencia y los factores de riesgo de las infecciones del VPH de alto riesgo, en mujeres de 21 a 65 años de tres cantones de la zona 6 del Ecuador, periodo 2019. Este fue un estudio analítico, de corte transversal; con una muestra de registros clínicos de 109 pacientes encuestadas a partir del proyecto de epidemiologia en la provincia de El Oro que cumplieron los criterios inclusión. Los datos se recogieron en un formulario validado por método Delphi. Se usó programa SPSS v 24, para la asociación de las variables: Intervalo de Confianza 95%, Chi cuadrado (con valor de p < 0.05), Odds Ratio. Los resultados observados fueron de 31 (28,4%) casos de pacientes con VPH AR, de estas se identificó como el genotipo más común al VPH AR 39 (11,01%) en las participantes del estudio, seguido del VPH AR 31 (8,26%). Fueron factores considerados asociados a la infección del VPH AR sin significancia estadística el inicio de la vida sexual (IVSA) antes de los 20 años (OR = 1,2); y el número de parejas sexuales igual o mayor a 2 (OR = 1,7). Se concluye que el inicio de vida sexual temprano y el numero compañeros sexuales fueron factores asociados, pero sin significancia estadística.

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“…Today, the most commonly used method of triage is cytology. Increases in colposcopies and in detection of benign or low-grade dysplasia with HPV screening compared to cytology screening are reported from the Netherlands among other countries, even though triage is implemented [ 1 , 12 , 13 ]. This lower specificity of the HPV test dictates the necessity of use of other triage tests in current HPV screening strategies, which can select women for colposcopy more accurately [ 5 ] and thus minimize the clinically irrelevant findings.…”

Section: Introductionmentioning

confidence: 99%

Molecular triage of cervical screening samples in women 55–59 years of age: a pilot study

Helenius

Lillsunde-Larsson

Bergengren

2023

Infect Agents Cancer

Self Cite

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Background With HPV screening the specificity of screening positives has decreased, even with a cytological triage test. Increases in colposcopies and detection of benign or low-grade dysplasia are reported, not least in older women. These results highlight the necessity to find other triage tests in HPV screening strategies, so that women can be more accurately selected for colposcopy, thus minimizing the clinically irrelevant findings. Methods The study included 55- to 59-year-old women who exited the screening with normal cytology, but later in a follow-up test were positive for the HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 and had a cervical cone biopsy done. To model a screening situation with hrHPV-positive women, three different triage strategies, namely, cytology, genotyping and methylation, were performed. The study considered the effect of direct referral to colposcopy for HPV genotypes 16, 18, 31, 33, 45, 52 and 58, and methylation for FAM19A4 and hsa-mir124-2 and/or any form of abnormal cytology. Results Seven out of 49 women aged 55–59 years with hrHPV had a cone biopsy with high-grade squamous intraepithelial lesion. No triage method found all cases, and when comparing positive and negative predictive value and false negative rate, cytology showed better results than genotyping and methylation. Conclusion This study does not support a switch in triage strategies from cytology to hrHPV genotyping and methylation for women above 55 years of age yet, but demonstrates the need for more evidence on molecular triage strategies.

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Effectiveness and costs of an implemented primary HPV cervical screening programme in Sweden – A population based cohort study

Cited by 8 publications

References 25 publications

Cervical Cancer Prophylaxis—State-of-the-Art and Perspectives

Cervical Cancer Prophylaxis—State-of-the-Art and Perspectives

Virus del papiloma humano de alto riesgo y factores asociados en mujeres de Ecuador

Molecular triage of cervical screening samples in women 55–59 years of age: a pilot study

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