Introducing a high-risk HPV DNA test into a public sector screening program in El Salvador

Miriam L. Cremer, Mauricio Maza, Karla M. Alfaro, Jane J. Kim, Lauren R. Ditzian, Sofia Villalta, Todd A. Alonzo, Juan C. Felix, Philip E. Castle, Julia C. Gage

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

A pilot program introducing HPV testing as part of a public sector screening program was successfully and effectively implemented in a low-resource setting. Objective In a primary human papillomavirus (HPV) screening program, we compared the 6-month follow-up among colposcopy and noncolposcopy-based management strategies for screen-positive women. Materials and Methods Women aged 30 to 49 years were screened with HPV DNA tests using both self-collection and provider collection of samples. Women testing positive received either (1) colposcopy management (CM) consisting of colposcopy and management per local guidelines or (2) screen-and-treat (ST) management using visual inspection with acetic acid to determine cryotherapy eligibility, with eligible women undergoing immediate cryotherapy. One thousand women were recruited in each cohort. Of these, 368 (18.4%) of 2000 women were recruited using a more intensive outreach strategy. Demographics, HPV positivity, and treatment compliance were compared across recruitment and management strategies. Results More women in the ST cohort received treatment within 6 months compared with those in the CM cohort (117/119 [98.3%] vs 64/93 [68.8%]; p <.001). Women recruited through more intensive outreach were more likely to be HPV positive, lived in urban areas, were more educated, and had higher numbers of lifetime sexual partners and fewer children. Conclusions Women in the CM arm were less likely to complete care than women in the ST arm. Targeted outreach to underscreened women successfully identified women with higher prevalence of HPV and possibly higher disease burden.

Original languageEnglish (US)
Pages (from-to)145-150
Number of pages6
JournalJournal of Lower Genital Tract Disease
Volume20
Issue number2
DOIs
StatePublished - Apr 1 2016

Fingerprint

Human Papillomavirus DNA Tests
El Salvador
Public Sector
Colposcopy
Cryotherapy
Sexual Partners

Keywords

  • Care HPV
  • Cervical cancer
  • Human papillomavirus
  • Latin America
  • Screening program

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Cremer, M. L., Maza, M., Alfaro, K. M., Kim, J. J., Ditzian, L. R., Villalta, S., ... Gage, J. C. (2016). Introducing a high-risk HPV DNA test into a public sector screening program in El Salvador. Journal of Lower Genital Tract Disease, 20(2), 145-150. https://doi.org/10.1097/LGT.0000000000000188

Introducing a high-risk HPV DNA test into a public sector screening program in El Salvador. / Cremer, Miriam L.; Maza, Mauricio; Alfaro, Karla M.; Kim, Jane J.; Ditzian, Lauren R.; Villalta, Sofia; Alonzo, Todd A.; Felix, Juan C.; Castle, Philip E.; Gage, Julia C.

In: Journal of Lower Genital Tract Disease, Vol. 20, No. 2, 01.04.2016, p. 145-150.

Research output: Contribution to journalArticle

Cremer, ML, Maza, M, Alfaro, KM, Kim, JJ, Ditzian, LR, Villalta, S, Alonzo, TA, Felix, JC, Castle, PE & Gage, JC 2016, 'Introducing a high-risk HPV DNA test into a public sector screening program in El Salvador', Journal of Lower Genital Tract Disease, vol. 20, no. 2, pp. 145-150. https://doi.org/10.1097/LGT.0000000000000188
Cremer, Miriam L. ; Maza, Mauricio ; Alfaro, Karla M. ; Kim, Jane J. ; Ditzian, Lauren R. ; Villalta, Sofia ; Alonzo, Todd A. ; Felix, Juan C. ; Castle, Philip E. ; Gage, Julia C. / Introducing a high-risk HPV DNA test into a public sector screening program in El Salvador. In: Journal of Lower Genital Tract Disease. 2016 ; Vol. 20, No. 2. pp. 145-150.
@article{bf9cd20fc01c49d88761adc0c0095f88,
title = "Introducing a high-risk HPV DNA test into a public sector screening program in El Salvador",
abstract = "A pilot program introducing HPV testing as part of a public sector screening program was successfully and effectively implemented in a low-resource setting. Objective In a primary human papillomavirus (HPV) screening program, we compared the 6-month follow-up among colposcopy and noncolposcopy-based management strategies for screen-positive women. Materials and Methods Women aged 30 to 49 years were screened with HPV DNA tests using both self-collection and provider collection of samples. Women testing positive received either (1) colposcopy management (CM) consisting of colposcopy and management per local guidelines or (2) screen-and-treat (ST) management using visual inspection with acetic acid to determine cryotherapy eligibility, with eligible women undergoing immediate cryotherapy. One thousand women were recruited in each cohort. Of these, 368 (18.4{\%}) of 2000 women were recruited using a more intensive outreach strategy. Demographics, HPV positivity, and treatment compliance were compared across recruitment and management strategies. Results More women in the ST cohort received treatment within 6 months compared with those in the CM cohort (117/119 [98.3{\%}] vs 64/93 [68.8{\%}]; p <.001). Women recruited through more intensive outreach were more likely to be HPV positive, lived in urban areas, were more educated, and had higher numbers of lifetime sexual partners and fewer children. Conclusions Women in the CM arm were less likely to complete care than women in the ST arm. Targeted outreach to underscreened women successfully identified women with higher prevalence of HPV and possibly higher disease burden.",
keywords = "Care HPV, Cervical cancer, Human papillomavirus, Latin America, Screening program",
author = "Cremer, {Miriam L.} and Mauricio Maza and Alfaro, {Karla M.} and Kim, {Jane J.} and Ditzian, {Lauren R.} and Sofia Villalta and Alonzo, {Todd A.} and Felix, {Juan C.} and Castle, {Philip E.} and Gage, {Julia C.}",
year = "2016",
month = "4",
day = "1",
doi = "10.1097/LGT.0000000000000188",
language = "English (US)",
volume = "20",
pages = "145--150",
journal = "Journal of Lower Genital Tract Disease",
issn = "1089-2591",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Introducing a high-risk HPV DNA test into a public sector screening program in El Salvador

AU - Cremer, Miriam L.

AU - Maza, Mauricio

AU - Alfaro, Karla M.

AU - Kim, Jane J.

AU - Ditzian, Lauren R.

AU - Villalta, Sofia

AU - Alonzo, Todd A.

AU - Felix, Juan C.

AU - Castle, Philip E.

AU - Gage, Julia C.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - A pilot program introducing HPV testing as part of a public sector screening program was successfully and effectively implemented in a low-resource setting. Objective In a primary human papillomavirus (HPV) screening program, we compared the 6-month follow-up among colposcopy and noncolposcopy-based management strategies for screen-positive women. Materials and Methods Women aged 30 to 49 years were screened with HPV DNA tests using both self-collection and provider collection of samples. Women testing positive received either (1) colposcopy management (CM) consisting of colposcopy and management per local guidelines or (2) screen-and-treat (ST) management using visual inspection with acetic acid to determine cryotherapy eligibility, with eligible women undergoing immediate cryotherapy. One thousand women were recruited in each cohort. Of these, 368 (18.4%) of 2000 women were recruited using a more intensive outreach strategy. Demographics, HPV positivity, and treatment compliance were compared across recruitment and management strategies. Results More women in the ST cohort received treatment within 6 months compared with those in the CM cohort (117/119 [98.3%] vs 64/93 [68.8%]; p <.001). Women recruited through more intensive outreach were more likely to be HPV positive, lived in urban areas, were more educated, and had higher numbers of lifetime sexual partners and fewer children. Conclusions Women in the CM arm were less likely to complete care than women in the ST arm. Targeted outreach to underscreened women successfully identified women with higher prevalence of HPV and possibly higher disease burden.

AB - A pilot program introducing HPV testing as part of a public sector screening program was successfully and effectively implemented in a low-resource setting. Objective In a primary human papillomavirus (HPV) screening program, we compared the 6-month follow-up among colposcopy and noncolposcopy-based management strategies for screen-positive women. Materials and Methods Women aged 30 to 49 years were screened with HPV DNA tests using both self-collection and provider collection of samples. Women testing positive received either (1) colposcopy management (CM) consisting of colposcopy and management per local guidelines or (2) screen-and-treat (ST) management using visual inspection with acetic acid to determine cryotherapy eligibility, with eligible women undergoing immediate cryotherapy. One thousand women were recruited in each cohort. Of these, 368 (18.4%) of 2000 women were recruited using a more intensive outreach strategy. Demographics, HPV positivity, and treatment compliance were compared across recruitment and management strategies. Results More women in the ST cohort received treatment within 6 months compared with those in the CM cohort (117/119 [98.3%] vs 64/93 [68.8%]; p <.001). Women recruited through more intensive outreach were more likely to be HPV positive, lived in urban areas, were more educated, and had higher numbers of lifetime sexual partners and fewer children. Conclusions Women in the CM arm were less likely to complete care than women in the ST arm. Targeted outreach to underscreened women successfully identified women with higher prevalence of HPV and possibly higher disease burden.

KW - Care HPV

KW - Cervical cancer

KW - Human papillomavirus

KW - Latin America

KW - Screening program

UR - http://www.scopus.com/inward/record.url?scp=84958818153&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84958818153&partnerID=8YFLogxK

U2 - 10.1097/LGT.0000000000000188

DO - 10.1097/LGT.0000000000000188

M3 - Article

VL - 20

SP - 145

EP - 150

JO - Journal of Lower Genital Tract Disease

JF - Journal of Lower Genital Tract Disease

SN - 1089-2591

IS - 2

ER -