[State of knowledge: comparison of cervical cancer screening strategies involving the human papillomavirus screening test (HPV test) or gynecological cytology (Pap test)]
Lessard J, Moqadem K
Record ID 32018001003
French
Original Title:
État des connaissances: comparaison des stratégies de dépistage du cancer du col de l'utérus avec le test de détection des virus du papillome humain (test VPH) ou la cytologie gynécologique (test Pap)
Authors' objectives:
The Canadian Cancer Society (CCS) estimates that 280 new cases of cervical cancer will be diagnosed and 80 cervical cancer deaths recorded in Québec in 2016. Given that an HPV vaccination program has been put in place in Québec, and because of changes in cervical cancer screening practice worldwide, which has shifted more to the use of the HPV test, the Direction générale de cancérologie (DGC) asked the Institut national d’excellence en santé et en services sociaux (INESSS), in collaboration with experts in the area, to compare the validity, efficacy and safety of the HPV test with those of the Pap test. To this end, the screening strategies recently recommended by experts from different authorities, organizations and associations were reviewed.
Authors' results and conclusions:
RESULTS: In a population-based screening context, the use of a triage strategy should reduce the rate of unnecessary referrals for a colposcopy and permit an adequate follow-up of women. In addition, adherence to the recommendations in terms of age and the prescribed screening interval, as well as the arrival of vaccinated populations at the age of screening, could reduce the risks associated with an increased number of colposcopies and optimize the use of the HPV test.
Authors' recommendations:
The HPV test is recommended as the only test for primary screening in a number of countries and by authorities around the world. A single screening strategy should target both unvaccinated and vaccinated women. The strategies should be reviewed on a regular basis as the population effect of vaccination is achieved. Combining vaccination and screening is the best strategy for preventing cervical cancer.
Authors' methods:
Meta-analyses have shown that the HPV test is significantly more sensitive than cytology. The specificity of the HPV test is lower than that of the Pap test. The data on these tests’ performance in vaccinated populations are incomplete and are insufficient for accurately ruling on the impact of vaccination on these screening tests’ sensitivity and specificity.
Details
Project Status:
Completed
Year Published:
2017
English language abstract:
An English language summary is available
Publication Type:
Other
Country:
Canada
Province:
Quebec
MeSH Terms
- Uterine Cervical Neoplasms
- Cervical Intraepithelial Neoplasia
- Vaginal Smears
- Mass Screening
- Early Detection of Cancer
- Papanicolaou Test
- Human Papillomavirus DNA Tests
- Papillomaviridae
- Papillomavirus Infections
- Female
- Colposcopy
Keywords
- Cervical cancer
- Screening test
Contact
Organisation Name:
Institut national d'excellence en sante et en services sociaux
Contact Address:
L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369
Contact Name:
demande@inesss.qc.ca
Contact Email:
demande@inesss.qc.ca
Copyright:
Gouvernement du Québec
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