title: Implementation of HPV-testing for cervical cancer screening in programmatic contexts: The Jujuy demonstration project in Argentina.
abstract: The aim of this article is to present results of programmatic introduction of HPV testing with cytologic triage among women 30 years and older in the province of Jujuy, Argentina, including description of the planning phase and results of program performance during the first year. We describe the project implementation process, and calculate key performance indicators using SITAM, the national screening information system. We also compare disease detection rates of HPV testing in 2012 with cytology as performed during the previous year. HPV testing with cytology triage was introduced through a consensus-building process. Key activities included establishment of algorithms and guidelines, creating the HPV laboratory, training of health professionals, information campaigns for women and designing the referral network. By the end of 2012, 100% (n = 270) of public health care centers were offering HPV testing and 22,834 women had been HPV tested, 98.5% (n = 22,515) were 30+. HPV positivity among women over 30 was 12.7%, 807 women were HPV+ and had abnormal cytology, and 281 CIN2+ were identified. CIN2+ detection rates was 1.25 in 2012 and 0.62 in 2011 when the program was cytology based (p = 0.0002). This project showed that effective introduction of HPV testing in programmatic contexts of low-middle income settings is feasible and detects more disease than cytology.
authors: Consejo Nacional de Investigaciones Científicas y Técnicas/Centro de Estudios de Estado y Sociedad, Sánchez de Bustamante 27, Buenos Aires, Argentina.
authors: Silvina
authors: S
authors: Arrossi
authors: Programa Nacional de Prevención de Cáncer Cervicouterino/Instituto Nacional del Cáncer (Argentina), Julio A. Roca 781, Piso 9, Buenos Aires, Argentina.
authors: Laura
authors: L
authors: Thouyaret
authors: Programa Nacional de Prevención de Cáncer Cervicouterino/Instituto Nacional del Cáncer, Rivadavia 875, Buenos Aires, Argentina.
authors: Rosa
authors: R
authors: Laudi
authors: Hospital Pablo Soria, Güemes 1345, San Salvador de Jujuy, Argentina.
authors: Oscar
authors: O
authors: Marín
authors: Ministerio de Salud de la provincia de Jujuy, Av. Italia Esq, Independencia, San Salvador de Jujuy, Argentina.
authors: Josefina
authors: J
authors: Ramírez
authors: Programa Nacional de Prevención de Cáncer Cervicouterino/Instituto Nacional del Cáncer (Argentina), Julio A. Roca 781, Piso 9, Buenos Aires, Argentina.
authors: Melisa
authors: M
authors: Paolino
authors: International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, France.
authors: Rolando
authors: R
authors: Herrero
authors: Ministerio de Salud de la Provincia de Jujuy, Av. Italia Esq, Independencia, San de Salvador de Jujuy, Argentina.
authors: Alicia
authors: A
authors: Campanera
mesh_terms: D000328:Adult; D000368:Aged; D001118:Argentina / Q000453:epidemiology; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*
keywords: Argentina; HPV test; cervical cancer prevention; screening