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Gates A, Pillay J, Reynolds D, Stirling R, Traversy G, Korownyk C, Moore A, Thériault G, Thombs BD, Little J, Popadiuk C, van Niekerk D, Keto-Lambert D, Vandermeer B, Hartling L. Screening for the prevention and early detection of cervical cancer: protocol for systematic reviews to inform Canadian recommendations. Syst Rev 2021; 10:2. [PMID: 33388083 PMCID: PMC7777363 DOI: 10.1186/s13643-020-01538-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/17/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To inform recommendations by the Canadian Task Force on Preventive Health Care on screening in primary care for the prevention and early detection of cervical cancer by systematically reviewing evidence of (a) effectiveness; (b) test accuracy; (c) individuals' values and preferences; and (d) strategies aimed at improving screening rates. METHODS De novo reviews will be conducted to evaluate effectiveness and to assess values and preferences. For test accuracy and strategies to improve screening rates, we will integrate studies from existing systematic reviews with search updates to the present. Two Cochrane reviews will provide evidence of adverse pregnancy outcomes from the conservative management of cervical intraepithelial neoplasia. We will search Medline, Embase, and Cochrane Central (except for individuals' values and preferences, where Medline, Scopus, and EconLit will be searched) via peer-reviewed search strategies and the reference lists of included studies and reviews. We will search ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. Two reviewers will screen potentially eligible studies and agree on those to include. Data will be extracted by one reviewer with verification by another. Two reviewers will independently assess risk of bias and reach consensus. Where possible and suitable, we will pool studies via meta-analysis. We will compare accuracy data per outcome and per comparison using the Rutter and Gatsonis hierarchical summary receiver operating characteristic model and report relative sensitivities and specificities. Findings on values and preferences will be synthesized using a narrative synthesis approach and thematic analysis, depending on study designs. Two reviewers will appraise the certainty of evidence for all outcomes using GRADE (Grading of Recommendations Assessment, Development and Evaluation) and come to consensus. DISCUSSION The publication of guidance on screening in primary care for the prevention and early detection of cervical cancer by the Task Force in 2013 focused on cytology. Since 2013, new studies using human papillomavirus tests for cervical screening have been published that will improve our understanding of screening in primary care settings. This review will inform updated recommendations based on currently available studies and address key evidence gaps noted in our previous review.
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Affiliation(s)
- Allison Gates
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue NW, Edmonton, Alberta T6G 1C9 Canada
| | - Jennifer Pillay
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue NW, Edmonton, Alberta T6G 1C9 Canada
| | - Donna Reynolds
- Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Rob Stirling
- Centre for Chronic Disease Prevention and Health Equity, Public Health Agency of Canada, Ottawa, Canada
| | - Gregory Traversy
- Centre for Chronic Disease Prevention and Health Equity, Public Health Agency of Canada, Ottawa, Canada
| | | | - Ainsley Moore
- Family Medicine, McMaster University, Hamilton, Canada
| | | | - Brett D. Thombs
- Faculty of Medicine, McGill University and Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Julian Little
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | | | - Dirk van Niekerk
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, Canada
| | - Diana Keto-Lambert
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue NW, Edmonton, Alberta T6G 1C9 Canada
| | - Ben Vandermeer
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue NW, Edmonton, Alberta T6G 1C9 Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue NW, Edmonton, Alberta T6G 1C9 Canada
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Taku O, Meiring TL, Gustavsson I, Phohlo K, Garcia-Jardon M, Mbulawa ZZA, Businge CB, Gyllensten U, Williamson AL. Acceptability of self- collection for human papillomavirus detection in the Eastern Cape, South Africa. PLoS One 2020; 15:e0241781. [PMID: 33170891 PMCID: PMC7654756 DOI: 10.1371/journal.pone.0241781] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022] Open
Abstract
Human papillomavirus (HPV) testing on vaginal self-collected and cervical clinician-collected specimens shows comparable performance. Self-sampling on FTA cards is suitable for women residing in rural settings or not attending regular screening and increases participation rate in the cervical cancer screening programme. We aimed to investigate and compare high-risk (HR)-HPV prevalence in clinician-collected and self-collected genital specimens as well as two different HPV tests on the clinician collected samples. A total of 737 women were recruited from two sites, a community health clinic (n = 413) and a referral clinic (n = 324) in the Eastern Cape Province. Cervical clinician-collected (FTA cards and Digene transport medium) and vaginal self-collected specimens were tested for HR-HPV using the hpVIR assay (FTA cards) and Hybrid Capture-2 (Digene transport medium). There was no significant difference in HR-HPV positivity between clinician-collected and self-collected specimens among women from the community-based clinic (26.4% vs 27.9%, p = 0.601) or the referral clinic (83.6% vs 79.9%, p = 0.222). HPV16, HPV35, and HPV33/52/58 group were the most frequently detected genotypes at both study sites. Self-sampling for HPV testing received a high positive response of acceptance (77.2% in the community-based clinic and 83.0% in referral clinic). The overall agreement between hpVIR assay and HC-2 was 87.7% (k = 0.754). The study found good agreement between clinician-collected and self-collected genital specimens. Self-collection can have a positive impact on a cervical screening program in South Africa by increasing coverage of women in rural areas, in particular those unable to visit the clinics and women attending clinics where cytology-based programs are not functioning effectively.
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Affiliation(s)
- Ongeziwe Taku
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Tracy L. Meiring
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Inger Gustavsson
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
| | - Keletso Phohlo
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Mirta Garcia-Jardon
- Department of Pathology at Walter Sisulu University and National Health Laboratory Service, Mthatha, South Africa
| | - Zizipho Z. A. Mbulawa
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, South Africa
- Department of Laboratory Medicine and Pathology, National Health Laboratory Service Nelson Mandela Academic Hospital and Walter Sisulu University, Mthatha, Eastern Cape, South Africa
- Medical Virology, National Health Laboratory Service, Nelson Mandela Academic Hospital, Mthatha, South Africa
| | - Charles B. Businge
- Department of Obstetrics and Gynaecology, Nelson Mandela Academic Hospital, Mthatha, South Africa
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Ulf Gyllensten
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory Uppsala, Uppsala University, Uppsala, Sweden
| | - Anna-Lise Williamson
- Division of Medical Virology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- SAMRC Gynaecological Cancer Research Centre, University of Cape Town, Cape Town, South Africa
- * E-mail:
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Chatzistamatiou K, Vrekoussis T, Tsertanidou A, Moysiadis T, Mouchtaropoulou E, Pasentsis K, Kitsou A, Moschaki V, Ntoula M, Zempili P, Halatsi D, Truva T, Piha V, Agelena G, Daponte A, Vanakara P, Paschopoulos M, Stefos T, Lymberis V, Kontomanolis EN, Makrigiannakis A, Deligeoroglou E, Panoskaltsis T, Adonakis G, Michail G, Stamatopoulos K, Agorastos T. Acceptability of Self-Sampling for Human Papillomavirus-Based Cervical Cancer Screening. J Womens Health (Larchmt) 2020; 29:1447-1456. [DOI: 10.1089/jwh.2019.8258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Kimon Chatzistamatiou
- 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Thomas Vrekoussis
- Department of Obstetrics and Gynecology, University of Crete, Herakleion University Hospital, Herakleion, Greece
| | - Athena Tsertanidou
- 3rd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece
| | - Theodoros Moysiadis
- Institute of Applied Biosciences, Centre for Research & Technology—Hellas, Thessaloniki, Greece
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | | | - Konstantinos Pasentsis
- Institute of Applied Biosciences, Centre for Research & Technology—Hellas, Thessaloniki, Greece
| | - Anastasia Kitsou
- 4th Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece
| | - Viktoria Moschaki
- Department of Neonatology, Hippokratio General Hospital, Midwifery Association of Thessaloniki, Thessaloniki, Greece
| | - Maria Ntoula
- Primary Health Care Unit 25th Martiou, Thessaloniki, Midwifery Network Coordinator, 4th Health District, Thessaloniki, Greece
| | - Paraskevi Zempili
- Department of Obstetrics and Gynecology, General Hospital of Komotini, Midwifery Association of Thrace, Komotini, Greece
| | - Despina Halatsi
- Department of Obstetrics and Gynecology, Hatzikosta General Hospital of Ioannina, Midwifery Association of Ioannina, Ioannina, Greece
| | - Theoni Truva
- Health Center Palama, Midwifery Association of Larissa, Karditsa, Greece
| | - Vaia Piha
- Department of Obstetrics and Gynecology, General Hospital of Chania, Midwifery Association of Crete, Chania, Greece
| | - Georgia Agelena
- Department of Obstetrics and Gynecology, General Hospital of Korinth, Midwifery Association of Nafplion, Korinth, Greece
| | - Alexandros Daponte
- Department of Obstetrics and Gynecology, University of Thessaly, Larissa University Hospital, Larissa, Greece
| | - Polyxeni Vanakara
- Department of Obstetrics and Gynecology, University of Thessaly, Larissa University Hospital, Larissa, Greece
| | - Minas Paschopoulos
- Department of Obstetrics and Gynecology, University of Ioannina, Ioannina University Hospital, Ioannina, Greece
| | - Theodoros Stefos
- Department of Obstetrics and Gynecology, University of Ioannina, Ioannina University Hospital, Ioannina, Greece
| | - Vasilis Lymberis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis University Hospital, Alexandroupolis, Greece
| | - Emmanuel N. Kontomanolis
- Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis University Hospital, Alexandroupolis, Greece
| | - Antonis Makrigiannakis
- Department of Obstetrics and Gynecology, University of Crete, Herakleion University Hospital, Herakleion, Greece
| | - Efthimios Deligeoroglou
- 2nd Department of Obstetrics and Gynecology, National Kapodistrian University of Athens, Aretaieion Hospital, Athens, Greece
| | - Theodoros Panoskaltsis
- 2nd Department of Obstetrics and Gynecology, National Kapodistrian University of Athens, Aretaieion Hospital, Athens, Greece
| | - George Adonakis
- Department of Obstetrics and Gynecology, University of Patras, Patras University Hospital, Patras, Greece
| | - George Michail
- Department of Obstetrics and Gynecology, University of Patras, Patras University Hospital, Patras, Greece
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research & Technology—Hellas, Thessaloniki, Greece
| | - Theodoros Agorastos
- 4th Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece
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