Implementation of HPV-testing for cervical cancer screening in programmatic contexts: final results of the Jujuy Demonstration Project in Argentina 2012-2014

ARROSSI S

Congreso; 31st International Papillomavirus Conference; 2017

ObjectivesWe present final results of the programmatic introduction of HPV-testing in the public health system of the province of Jujuy.MethodsHPV testing was introduced through clinician-collected tests at health centers (with triage cytology taken at the same time, only read if the test is positive), and self-collection (cytology triage taken at health centers). We analyzed data on all screening tests and diagnostic procedures of women aged 30+ attending the public health system in Jujuy during 2012-2014, using the national screening information system (SITAM). ResultsImplementation activities included roundtables with health authorities to monitor process outcomes, training of managers, health workers and professionals, information campaigns, organization of national meetings for dissemination of scientific evidence about HPV-testing, and patient navigation. Between 2012-2014, 49565 women aged 30+ were HPV-tested (98.8% of total HPV-tested women), 44700 with clinician collected tests (67% among screening under-users), 4865 with self-collection (85% among screening under-users). HPV-positivity was 13.7% and 13.0% among women with clinician-collected tests and self-collected tests respectively. 1663 women with clinician-collected tests were HPV+ and had abnormal cytology, among them, 74.6% complied with diagnostic procedures. Among women with self-collected tests, 69.4% had cytology triage, among those triage positive 70.0% complied with diagnostic procedures. CIN2+ detection rates were 1.23% and 0.7% for clinician collected tests and self-collection respectively. Conclusions This project showed that effective introduction of HPV-testing in programmatic contexts of low-middle income settings is feasible. Self-collection is an option for screener under-users, although cytology triage remains a problem.