Triage strategies in cervical cancer detection in Mexico: methods of the FRIDA Study
Document title: Triage strategies in cervical cancer detection in Mexico: methods of the FRIDA Study
Journal: Salud pública de México
Database: PERIÓDICA
System number: 000390265
ISSN: 0036-3634
Authors: 1
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Institutions: 1Instituto Nacional de Salud Pública, Centro de Investigación en Salud Poblacional, Cuernavaca, Morelos. México
2McGill University, Division of Cancer Epidemiology, Montreal, Quebec. Canadá
3Queen Mary University of London, Centre for Cancer Prevention, Londres. Reino Unido
4Instituto Mexicano del Seguro Social, Unidad de Investigación Epidemiológica y en Servicios de Salud, Cuernavaca, Morelos. México
5University of New Mexico, Department of Pathology, Albuquerque, Nuevo México. Estados Unidos de América
6University of California, Department of Pediactrics, Los Angeles, California. Estados Unidos de América
7University of Texas, Division of Gynecology Oncology and Reproductive Medicine, Houston, Texas. Estados Unidos de América
8University of California, Department of Health Policy and Management, Los Angeles, California. México
Year:
Season: Mar-Abr
Volumen: 58
Number: 2
Pages: 197-210
Country: México
Language: Inglés
Document type: Artículo
Approach: Aplicado, analítico
Spanish abstract de triage. Conclusión. Los resultados de este estudio ayudarán tanto a los tomadores de decisiones como a los proveedores de servicios de salud a establecer la mejor estrategia de triage en programas de tamizaje de cáncer cervical basados en VPHar en México y en otros países
English abstract Objective. This paper describes the study design and baseline characteristics of the study population, including the first 30 829 women who enrolled in the Forwarding Research for Improved Detection and Access for Cervical Cancer Screening and Triage (FRIDA Study). This is a large population based study that is evaluating the performance and cost-effectiveness of different triage strategies for high-risk HPV (hrHPV) positive women in Mexico. Materials and methods. The target population is more than 100 000 women aged 30 to 64 years who attend the Cervical Cancer Screening Program in 100 health centers in the state of Tlaxcala, Mexico. Since August 2013, all women in the region have been invited to enroll in the study. The study participants are evaluated to determine hrHPV infection using the Cobas 4800 HPV test. The HPV-16/18 genotyping and cytology triage strategies are performed as reflex tests in all hrHPV-positive participants. Women with a positive HPV-16/18 test and/or abnormal cytology (atypical squamous cells of undetermined significance or worse, ASCUS+) are referred for colposcopy evaluation, where a minimum of four biopsies and an endocervical sample are systematically collected. Histologic confirmation is performed by a standardized panel of pathologists. Results. Among the 30 829 women who have been screened, the overall prevalence of hrHPV is 11.0%. The overall prevalence of HPV16 and HPV18 are 1.5% and 0.7%, respectively. Cytological abnormalities (ASCUS+) were detected in 11.8% of the hrHPV-positive women. A total of 27.0% (920/3,401) of the hrHPV-positive women were referred to colposcopy because of a positive HPV16/18 test and/or abnormal reflex cytology, (31.6% had only ASCUS+, 53.6% were HPV16/18 positive with a normal cytology result, and 9.5% were positive to both triage tests). Conclusion. The results of this study will help policy makers and health service providers establish the best practices for triage in cervical cancer..
Disciplines: Medicina
Keyword: Ginecología y obstetricia,
Oncología,
Salud pública,
Cáncer,
Neoplasia intraepitelial,
Cérvix,
Sondas de ADN,
Papilomavirus,
Tamizaje,
Costo-efectividad
Keyword: Medicine,
Gynecology and obstetrics,
Oncology,
Public health,
Cancer,
Intraepithelial neoplasm,
Cervix,
DNA probes,
Papillomavirus,
Screening,
Cost-effectiveness
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