Factors associated with low adherence to cervical cancer follow-up retest among HPV+/ cytology negative women: a study in programmatic context in a low-income population in Argentina
Background Cervical Cancer is still a major public health challenge in low and middle-income countries. HPV testing has been an innovative approach, which was introduced in Argentina for women aged 30+ through the Jujuy Demonstration Project (JDP) carried out between 2012 and 2014. After a positive...
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Formato: | Artículo |
Lenguaje: | Inglés |
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1471-2407
2019
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Acceso en línea: | http://repositorio.cedes.org/handle/123456789/4507 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480915/ |
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I61-R167123456789-4507 |
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institution |
Centro de Estudios de Estado y Sociedad (CEDES) |
institution_str |
I-61 |
repository_str |
R-167 |
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Respositorio Digital CRIS del CEDES - Centro de Estudios de Estado y Sociedad |
language |
Inglés |
orig_language_str_mv |
en |
topic |
HPV Neoplasias del Cuello Uterino Cumplimiento y Adherencia al Tratamiento |
spellingShingle |
HPV Neoplasias del Cuello Uterino Cumplimiento y Adherencia al Tratamiento Arrossi, Silvina Paolino, Melisa Gago, Juan Factors associated with low adherence to cervical cancer follow-up retest among HPV+/ cytology negative women: a study in programmatic context in a low-income population in Argentina |
topic_facet |
HPV Neoplasias del Cuello Uterino Cumplimiento y Adherencia al Tratamiento |
description |
Background
Cervical Cancer is still a major public health challenge in low and middle-income countries. HPV testing has been an innovative approach, which was introduced in Argentina for women aged 30+ through the Jujuy Demonstration Project (JDP) carried out between 2012 and 2014. After a positive HPV-test, cytology is used as triage method. Under this protocol, the group of women with HPV+ and normal cytology are recommended to repeat the test within 12–18 months. Studies have shown that this group has increased risk of CIN2+, however, assuring high levels of repeating test among these women is difficult to achieve. We analyze those factors associated with lower re-test attendance among HPV+/ cytology negative women at a programmatic level in low-middle income settings.
Methods
We used data of women aged 30+ HPV-tested in the JDP and followed until 2018 (n = 49,565). We performed a set of different adjusted logistic regression models.
Primary outcomes were re-test attendance and re-test attendance within recommended timeframe. We assessed as covariates age, health insurance status, year of HPV-testing, Pap testing in the past 3 years, HPV-testing modality (clinician-collected (CC) tests/self-collected (SC) tests), and span between HPV-test collection and report of results.
Results
Forty nine thousand five hundred sixty five women were HPV-tested and 6742 had a positive HPV-test. Among HPV+ women, a total of 4522 were HPV+/Cytology negative (67.1%). In total, 3172 HPV+/Cytology negative women (70.1%) had a record of a second HPV test as of March 2018. Only 1196 women (26%) completed the second test within the timeframe. Women with no record of a previous Pap (OR: 0.46, 95% CI: 0.4–0.53, p < 0.001), aged 64+ (OR: 0.46, 95% CI: 0.31-0.68, p < 0.001) were less likely to be retested; while women with clinician-collected samples had higher odds of being re-tested (OR: 1.42, 95% CI: 1.06–1.91, p < 0.001).
Conclusions
Low re-test rates were found in HPV +/ normal cytology women. Tailored interventions are needed to increase the effectiveness of the screening in this group, especially for those women with characteristics associated to lower attendance. |
format |
Artículo |
author |
Arrossi, Silvina Paolino, Melisa Gago, Juan |
author_facet |
Arrossi, Silvina Paolino, Melisa Gago, Juan |
author_sort |
Arrossi, Silvina |
title |
Factors associated with low adherence to cervical cancer follow-up retest among HPV+/ cytology negative women: a study in programmatic context in a low-income population in Argentina |
title_short |
Factors associated with low adherence to cervical cancer follow-up retest among HPV+/ cytology negative women: a study in programmatic context in a low-income population in Argentina |
title_full |
Factors associated with low adherence to cervical cancer follow-up retest among HPV+/ cytology negative women: a study in programmatic context in a low-income population in Argentina |
title_fullStr |
Factors associated with low adherence to cervical cancer follow-up retest among HPV+/ cytology negative women: a study in programmatic context in a low-income population in Argentina |
title_full_unstemmed |
Factors associated with low adherence to cervical cancer follow-up retest among HPV+/ cytology negative women: a study in programmatic context in a low-income population in Argentina |
title_sort |
factors associated with low adherence to cervical cancer follow-up retest among hpv+/ cytology negative women: a study in programmatic context in a low-income population in argentina |
publisher |
1471-2407 |
publishDate |
2019 |
url |
http://repositorio.cedes.org/handle/123456789/4507 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480915/ |
work_keys_str_mv |
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bdutipo_str |
Repositorios |
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1764820545209106434 |