Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study.
| Title: | Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study. |
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| Authors: | Rol ML; Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France.; Picconi MA; Instituto de Enfermedades Infecciosas ANLIS-Malbrán, Buenos Aires, Argentina.; Ferrera A; Instituto de Investigaciones en Microbiología, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.; Sánchez GI; Grupo de Infección y Cáncer, Universidad de Antioquia, Medellín, Colombia.; Hernández ML; Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France.; SMS-Oncology, Amsterdam, Netherlands.; Lineros J; Instituto Nacional de Cancerología, Bogotá, Colombia.; Peraza A; Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San José, Costa Rica.; Brizuela M; Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San José, Costa Rica.; Mendoza L; Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay.; Mongelós P; Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay.; Cabrera Y; Grupo de Infección y Cáncer, Universidad de Antioquia, Medellín, Colombia.; Rodríguez de la Peña M; Hospital Nacional Profesor Alejandro Posadas, El Palomar, Argentina.; Correa RM; Instituto de Investigaciones en Microbiología, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.; Terán C; Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia.; Colque Reynaga D; Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia.; García L; Laboratorio de Biología Molecular, Departamento de Patología Clínica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay.; Ramírez AT; Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France.; Hernández-Nevarez P; Instituto de Salud Pública de México, Morelos, Mexico.; Doimi F; Laboratorio de Patología Oncológica SAC, Lima, Peru.; Ramón M; Laboratorio de Patología Oncológica SAC, Lima, Peru.; Arias-Stella J; Instituto de Patología y Biología Molecular, Lima, Peru.; Zúñiga M; Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación Inciensa, San José, Guanacaste, Costa Rica.; Villagra V; Laboratorio Central de Salud Pública, Asunción, Paraguay.; Bobadilla ML; Laboratorio Central de Salud Pública, Asunción, Paraguay.; Cardinal L; Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.; Valls J; Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France.; Lucas E; Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France.; Baena A; Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France.; Fleider L; Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.; Venegas G; Clínica Angloamericana, Lima, Peru.; Liga contra el Cáncer, Lima, Peru.; Cruz-Valdez A; Instituto de Salud Pública de México, Morelos, Mexico.; Rodríguez G; Comisión Honoraria de Lucha Contra el Cáncer, Montevideo, Uruguay.; Calderón A; Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San José, Costa Rica.; Wiesner C; Instituto Nacional de Cancerología, Bogotá, Colombia.; Luciani S; Pan American Health Organization (PAHO), Washington, DC, United States.; Broutet N; Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.; Herrero R; Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France.; Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación Inciensa, San José, Guanacaste, Costa Rica.; Almonte M; Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France.; Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland. |
| Source: | Frontiers in medicine [Front Med (Lausanne)] 2022 Nov 17; Vol. 9, pp. 1006038. Date of Electronic Publication: 2022 Nov 17 (Print Publication: 2022). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Frontiers Media S.A Country of Publication: Switzerland NLM ID: 101648047 Publication Model: eCollection Cited Medium: Print ISSN: 2296-858X (Print) Linking ISSN: 2296858X NLM ISO Abbreviation: Front Med (Lausanne) Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Lausanne, Switzerland : Frontiers Media S.A., [2014]- |
| Abstract: | Background: Replacement of cytology screening with HPV testing is recommended and essential for cervical cancer elimination. HPV testing for primary screening was implemented in 12 laboratories within 9 Latin American countries, as part of the ESTAMPA cervical cancer screening study. Our observations provide information on critical operational aspects for HPV testing implementation in diverse resource settings.; Methods: We describe the implementation process of HPV testing in ESTAMPA, focusing on laboratory aspects. We assess the readiness of 12 laboratories to start HPV testing and their continuity capacity to maintain good quality HPV testing until end of recruitment or up to December 2021. Readiness was based on a checklist. Information from the study database; regular meetings and monitoring visits; and a questionnaire on laboratory operational aspects sent in May 2020 were used to assess continuity capacity. Compliance with seven basic requirements (readiness) and eight continuity requirements (continuity capacity) was scored (1 = compliant, 0 = not compliant) and totaled to classify readiness and continuity capacity as very limited, limited, moderate or high. Experiences, challenges, and enablers of the implementation process are also described.; Results: Seven of 12 laboratories had high readiness, three moderate readiness, and of two laboratories new to HPV testing, one had limited readiness and the other very limited readiness. Two of seven laboratories with high readiness also showed high continuity capacity, one moderate continuity capacity, and the other four showed limited continuity capacity since they could not maintain good quality HPV testing over time. Among three laboratories with moderate readiness, one kept moderate continuity capacity and two reached high continuity capacity. The two laboratories new to HPV testing achieved high continuity capacity. Based on gained expertise, five laboratories have become part of national screening programs.; Conclusion: High readiness of laboratories is an essential part of effective implementation of HPV testing. However, high readiness is insufficient to guarantee HPV testing high continuity capacity, for which a "culture of quality" should be established with regular training, robust monitoring and quality assurance systems tailored to local context. All efforts to strengthen HPV laboratories are valuable and crucial to guarantee effective implementation of HPV-based cervical screening.; (Copyright © 2022 Rol, Picconi, Ferrera, Sánchez, Hernández, Lineros, Peraza, Brizuela, Mendoza, Mongelós, Cabrera, Rodríguez de la Peña, Correa, Terán, Colque Reynaga, García, Ramírez, Hernández-Nevarez, Doimi, Ramón, Arias-Stella, Zúñiga, Villagra, Bobadilla, Cardinal, Valls, Lucas, Baena, Fleider, Venegas, Cruz-Valdez, Rodríguez, Calderón, Wiesner, Luciani, Broutet, Herrero and Almonte.) |
| Competing Interests: | Author MH was employed by SMS-Oncology, Amsterdam, Netherlands. Author FD was employed by Laboratorio de Patología Oncológica, SAC, Peru. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. |
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| Grant Information: | 001 International WHO_ World Health Organization; UH3 CA202730 United States CA NCI NIH HHS |
| Contributed Indexing: | Keywords: ESTAMPA study; HPV testing; HPV testing implementation; Latin America; cervical cancer screening; readiness and continuity capacity |
| Entry Date(s): | Date Created: 20221205 Latest Revision: 20250530 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC9714610 |
| DOI: | 10.3389/fmed.2022.1006038 |
| PMID: | 36465901 |
| Database: | MEDLINE |
Journal Article