Revue: | Salud pública de México |
Base de datos: | PERIÓDICA |
Número de sistema: | 000390265 |
ISSN: | 0036-3634 |
Autores: | Torres Ibarra, Leticia1 Lazcano Ponce, Eduardo1 Franco, Eduardo L2 Jack Cuzick, Jack3 Hernández Avila, Mauricio1 Lorincz, Attila3 Rivera, Berenice1 Ramírez, Paula4 Mendiola Pastrana, Indira1 Rudolph, Samantha E4 León Maldonado, Leith1 Hernández, Rubí1 Barris, Elizabeth1 Gravitt, Patti5 Moscicki, Anna Barbara6 Schmeler, Kathleen M7 Flores, Yvonne N4 Méndez Hernández, Pablo8 Salmerón, Jorge1 |
Instituciones: | 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 |
Año: | 2016 |
Periodo: | Mar-Abr |
Volumen: | 58 |
Número: | 2 |
Paginación: | 197-210 |
País: | México |
Idioma: | Inglés |
Tipo de documento: | Artículo |
Enfoque: | Aplicado, analítico |
Resumen en español | 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 |
Resumen en inglés | 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.. |
Disciplinas: | Medicina |
Palabras clave: | 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 |
Texte intégral: | Texto completo (Ver HTML) |