HPV self-collection implementation in Tucuman, Argentina: analysis of adherence to cytology triage

ARROSSI SILVINA; GAGO, JUAN; LE PERA ANABELLA; CINTO OSCAR; THOUYARET, LAURA; PAOLINO MELISA

Congreso; 33 Conference of the International Papillomavirus Society; 2020

IntroductionHPV self-collection has been shown to reduce access barriers to screening. When using HPV self-collection, triage tests are a key step in cervical cancer prevention process. However, in middle income settings high adherence to triage has been difficult to obtain. The aim of this study was to measure adherence to triage by HPV positive women with self-collected tests in Tucuman province, Argentina.MethodsWe analyzed data on screening/triage/diagnosis/treatment from women aged 30+ who performed self-collection between 2015 and 2017, in the public health system in Tucuman, Argentina. Data source was the national screening information system (SITAM). We calculated: 1) % of adherence to triage, 2) % Adherence to colposcopy, and 3) Time between HPV self-collection and cytology triage. Results In the province of Tucuman programmatic, population based self-collection was implemented in 2015. Between 2015-2017, a total of 15,765 women aged 30 and older were HPV-screened through self-collection (40.1% of total HPV-testing). Mean age of screened women was 43 (range 30-86), 16.2% had a record of previous PAP-based screening and 55.2% had public health insurance. In total, 2391 women with self-collected tests were HPV positive (15.2%) and among them 1120 (46.8%) completed cytology triage. The percentage of women completing cytology triage within 120 days was 30.9% in 2015, 19.9% in 2016 and 23.4% for 2017. Among women with an abnormal cytology, 60.0% performed a colposcopy, of which 72.2% resulted in pathological results. The number of CIN2+ cases confirmed by histology was 78. ConclusionsOur results showed that adherence to triage by women with self-collected tests is challenging. Special efforts should be devoted to increase adherence to follow up among these women.