The possible effects on socio-economic inequalities of introducing HPV-testing as primary test in cervical cancer screening programs.
Background <br/>HPV-test is more effective than Pap test in preventing cervical cancer. HPV-based screening will imply longer intervals and a triage test for HPV positive women. It will also permit the use of self-sampling devices. <br/>These innovations may affect population coverage, p...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2014-02-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fonc.2014.00020/full |
| _version_ | 1819242028723077120 |
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| author | Paolo eGiorgi Rossi Flavia eBaldacchini Guglielmo eRonco |
| author_facet | Paolo eGiorgi Rossi Flavia eBaldacchini Guglielmo eRonco |
| author_sort | Paolo eGiorgi Rossi |
| collection | DOAJ |
| description | Background <br/>HPV-test is more effective than Pap test in preventing cervical cancer. HPV-based screening will imply longer intervals and a triage test for HPV positive women. It will also permit the use of self-sampling devices. <br/>These innovations may affect population coverage, participation, and compliance to protocols, and likely in a different way for less educated, poorer, and disadvantaged women. <br/>Aim <br/>To describe the impact on inequalities, actual or presumed, of the introduction of HPV-based screening. <br/>Methods <br/>The putative HPV-based screening algorithm has been analysed to identify critical points for inequalities. A systematic review of the literature has been conducted searching PubMed on HPV screening coverage, participation, and compliance. Results were summarised in a narrative synthesis. <br/>Results <br/>Knowledge about HPV and cervical cancer was lower in women with low Socio-economic status and in disadvantaged groups. A correct communication can reduce differences. <br/>Longer intervals will make it easier to achieve high-population coverage, but higher cost of the test in private providers could reduce the use of opportunistic screening by disadvantaged women. <br/>There are some evidences that inviting for HPV test instead of Pap increases participation, but there are no data on social differences. <br/>Self-sampling devices are effective in increasing participation and coverage. Some studies showed that the acceptability of self-sampling is higher in more educated women, but there is also an effect on hard-to-reach women. <br/>Communication of HPV positivity may increase anxiety and impact on sexual behaviours, the effect is stronger in low educated and disadvantaged women. <br/>Many studies found indirect evidence that unvaccinated women are or will be more probably under-screened. <br/>Conclusions <br/>The introduction of HPV test may increase population coverage, but non-compliance to protocols and interaction with opportunistic screening can increase existing inequalities. |
| first_indexed | 2024-12-23T14:33:18Z |
| format | Article |
| id | doaj.art-a2fce2cd2400413bb421b2e42ca6fb80 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-23T14:33:18Z |
| publishDate | 2014-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-a2fce2cd2400413bb421b2e42ca6fb802022-12-21T17:43:25ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2014-02-01410.3389/fonc.2014.0002077057The possible effects on socio-economic inequalities of introducing HPV-testing as primary test in cervical cancer screening programs.Paolo eGiorgi Rossi0Flavia eBaldacchini1Guglielmo eRonco2Azienda USL Reggio EmiliaAzienda USL Reggio EmiliaCentro per la Prevenzione Oncologica, PiemonteBackground <br/>HPV-test is more effective than Pap test in preventing cervical cancer. HPV-based screening will imply longer intervals and a triage test for HPV positive women. It will also permit the use of self-sampling devices. <br/>These innovations may affect population coverage, participation, and compliance to protocols, and likely in a different way for less educated, poorer, and disadvantaged women. <br/>Aim <br/>To describe the impact on inequalities, actual or presumed, of the introduction of HPV-based screening. <br/>Methods <br/>The putative HPV-based screening algorithm has been analysed to identify critical points for inequalities. A systematic review of the literature has been conducted searching PubMed on HPV screening coverage, participation, and compliance. Results were summarised in a narrative synthesis. <br/>Results <br/>Knowledge about HPV and cervical cancer was lower in women with low Socio-economic status and in disadvantaged groups. A correct communication can reduce differences. <br/>Longer intervals will make it easier to achieve high-population coverage, but higher cost of the test in private providers could reduce the use of opportunistic screening by disadvantaged women. <br/>There are some evidences that inviting for HPV test instead of Pap increases participation, but there are no data on social differences. <br/>Self-sampling devices are effective in increasing participation and coverage. Some studies showed that the acceptability of self-sampling is higher in more educated women, but there is also an effect on hard-to-reach women. <br/>Communication of HPV positivity may increase anxiety and impact on sexual behaviours, the effect is stronger in low educated and disadvantaged women. <br/>Many studies found indirect evidence that unvaccinated women are or will be more probably under-screened. <br/>Conclusions <br/>The introduction of HPV test may increase population coverage, but non-compliance to protocols and interaction with opportunistic screening can increase existing inequalities.http://journal.frontiersin.org/Journal/10.3389/fonc.2014.00020/fullComplianceMass ScreeningHuman papillomaviruscoveragesocial inequalitiesParticipation |
| spellingShingle | Paolo eGiorgi Rossi Flavia eBaldacchini Guglielmo eRonco The possible effects on socio-economic inequalities of introducing HPV-testing as primary test in cervical cancer screening programs. Frontiers in Oncology Compliance Mass Screening Human papillomavirus coverage social inequalities Participation |
| title | The possible effects on socio-economic inequalities of introducing HPV-testing as primary test in cervical cancer screening programs. |
| title_full | The possible effects on socio-economic inequalities of introducing HPV-testing as primary test in cervical cancer screening programs. |
| title_fullStr | The possible effects on socio-economic inequalities of introducing HPV-testing as primary test in cervical cancer screening programs. |
| title_full_unstemmed | The possible effects on socio-economic inequalities of introducing HPV-testing as primary test in cervical cancer screening programs. |
| title_short | The possible effects on socio-economic inequalities of introducing HPV-testing as primary test in cervical cancer screening programs. |
| title_sort | possible effects on socio economic inequalities of introducing hpv testing as primary test in cervical cancer screening programs |
| topic | Compliance Mass Screening Human papillomavirus coverage social inequalities Participation |
| url | http://journal.frontiersin.org/Journal/10.3389/fonc.2014.00020/full |
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