OBJECTIVE: We report performance indicators and costs of the first round of a cervical cancer screening programme based on the human papillomavirus (HPV)-DNA test. METHODS: We implemented a demonstration study using HPV as the primary test in Guidonia, Italy (90,000 inhabitants). All women aged 25-64 were invited to undergo a Hybrid Capture II high-risk HPV test. Two cervical samplings, smear and liquid, were taken. The smear was dyed and interpreted only for HPV-positive (HPV+) women. Women with a non-negative Pap smear were referred for colposcopy, women HPV+/cytology negative were referred to one-year follow-up with HPV. A cost-analysis indicated the price at which the HPV-based and cytological screening would cost the same per screened woman and per lesion found. RESULTS: Of 24,000 women invited, 7639 accepted and 427 (5.6%) were HPV+; 141 (34%) of these had a non-negative Pap test, and 20 cervical intraepithelial neoplasia (CIN) 2 or higher were found (positive predictive value 15%). Compliance to one-year follow-up was 58% (166/286); 90 (54%) were HPV-positive and five additional lesions were found (positive predictive value 9%; overall detection rate 3.4/1000). The cost analysis showed that at a price of 8.3 euros per HPV-DNA test, the strategy using HPV as primary test followed by cytological triage would cost the same per screened woman, while at a price of 12.7 euros it would have the same cost per CIN2+ found. CONCLUSION: The workload for management of positive women was similar to cytological screening. Low compliance to one-year follow-up was the main barrier to effectiveness. The price of HPV test should be about 9 euros to maintain the same screening budget, and can go as high as 13 euros per lesion found.
OBJECTIVE: We report performance indicators and costs of the first round of a cervical cancer screening programme based on the human papillomavirus (HPV)-DNA test. METHODS: We implemented a demonstration study using HPV as the primary test in Guidonia, Italy (90,000 inhabitants). All women aged 25-64 were invited to undergo a Hybrid Capture II high-risk HPV test. Two cervical samplings, smear and liquid, were taken. The smear was dyed and interpreted only for HPV-positive (HPV+) women. Women with a non-negative Pap smear were referred for colposcopy, womenHPV+/cytology negative were referred to one-year follow-up with HPV. A cost-analysis indicated the price at which the HPV-based and cytological screening would cost the same per screened woman and per lesion found. RESULTS: Of 24,000 women invited, 7639 accepted and 427 (5.6%) were HPV+; 141 (34%) of these had a non-negative Pap test, and 20 cervical intraepithelial neoplasia (CIN) 2 or higher were found (positive predictive value 15%). Compliance to one-year follow-up was 58% (166/286); 90 (54%) were HPV-positive and five additional lesions were found (positive predictive value 9%; overall detection rate 3.4/1000). The cost analysis showed that at a price of 8.3 euros per HPV-DNA test, the strategy using HPV as primary test followed by cytological triage would cost the same per screened woman, while at a price of 12.7 euros it would have the same cost per CIN2+ found. CONCLUSION: The workload for management of positive women was similar to cytological screening. Low compliance to one-year follow-up was the main barrier to effectiveness. The price of HPV test should be about 9 euros to maintain the same screening budget, and can go as high as 13 euros per lesion found.
Authors: P Giorgi Rossi; C Fortunato; P Barbarino; S Boveri; S Caroli; A Del Mistro; A Ferro; C Giammaria; M Manfredi; T Moretto; A Pasquini; M Sideri; M C Tufi; C Cogo; E Altobelli Journal: Br J Cancer Date: 2015-01-29 Impact factor: 7.640
Authors: Tiziano Maggino; Rocco Sciarrone; Bruno Murer; Maria Rosa Dei Rossi; Chiara Fedato; Michela Maran; Melania Lorio; Marika Soldà; Fiorella Zago; Paolo Giorgi Rossi; Manuel Zorzi Journal: Br J Cancer Date: 2016-08-04 Impact factor: 7.640
Authors: Matejka Rebolj; Janet Rimmer; Karin Denton; John Tidy; Christopher Mathews; Kay Ellis; John Smith; Chris Evans; Thomas Giles; Viki Frew; Xenia Tyler; Alexandra Sargent; Janet Parker; Miles Holbrook; Katherine Hunt; Penny Tidbury; Tanya Levine; David Smith; Julietta Patnick; Ruth Stubbs; Sue Moss; Henry Kitchener Journal: BMJ Date: 2019-02-06