Adherence to follow-up and treatment in a Screening program based on HPV testing in Jujuy, Argentina

ARROSSI S; THOUYARET L; BARLETTA P; PAOLINO M; CAMPANERA A

Congreso; International Conference on HPV 2014; 2014

Background   Jujuy is the first Argentinean province to have introduced HP-testing as primary screening in 2012. One key issue is follow-up of women tested positive for HR-HPV.   Objectives To describe adherence to follow-up/treatment of HPV+ women who had an abnormal Pap-smear in the context of a screening program based on HPV-testing.   Methodology We analyzed data on all screening tests and diagnostic procedures of women aged 30+ attending the public health system in Jujuy during 2012, using the national screening information system (SITAM). We also analyzed reports from the navigators team (Provincial Program on Cervical Cancer Prevention), who contact women with problems to access diagnosis/treatment to provide support.   Results   Of the 22515 women HPV-tested during 2012, 2861 (12.7%) were HPV+. Among them, 807 had abnormal Pap-smears (ASCUS +), of these 627 (77.8%) had colposcopy at public health centers, 19 (2.4%) had colposcopy at private services, 15 moved/ did not accept treatment (1.8%), 26 (3.2%) had a second negative test and 120 (14.8%) were lost to colposcopy. In total 85.1% (687/807) of women tested HPV+ with abnormal Pap were contacted by the navigators team.   Of the 627 colposcopies from public health services, 133 (21.2%) were normal. Among the 494 women with abnormal colposcopies, 453 (91.7%) of them were biopsied at public health services and had results in SITAM (Normal/CIN1=172; CIN2+=281); 31 (6.3%) women reported having had a biopsy, but results were not available, the rest (n=10; 2.0%) were lost to biopsy.   Among 281 CIN2+ women with biopsy at public health centers, 191 (67.9%) received treatment.   Conclusion Although in the context of HPV-testing in Jujuy, the number of women aged 30+ who needed colposcopy was three times higher than in the previous cytology-based program, our results indicate that the public health system was able to reach a majority of women who needed follow-up/treatment.