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The clinical implementation of primary HPV screening
Author(s) -
Mariani Luciano,
Igidbashian Sarah,
Sandri Maria Teresa,
Vici Patrizia,
Landoni Fabio
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12065
Subject(s) - medicine , perspective (graphical) , primary care , population , family medicine , gynecology , health care , public health , test (biology) , pathology , economics , economic growth , paleontology , environmental health , artificial intelligence , computer science , biology
Objective To evaluate, from a gynecology perspective, the transition from cytology‐based HPV screening to primary HPV screening. Methods Studies examining switching from cytology‐based screening to primary HPV ‐ DNA testing with triaging of patients with positive test results were retrieved and reviewed, with a particular focus on screening in an Italian setting. Results The increased complexity of patient‐management decisions when implementing HPV ‐based screening was a critical issue discussed in the literature. The change in strategy represents a paradigm shift in moving from a medical perspective of identifying the disease in individual patients, to a public‐healthcare perspective of excluding HPV from the healthy population and identifying a small sub‐group of individuals at increased risk of HPV . Conclusion With knowledge about HPV screening evolving rapidly, new programs and related algorithms need to be sufficiently flexible to be adjusted according to ongoing research and the validation of new assays. The establishment of a national working group (including epidemiologists, gynecologists, pathologists, and healthcare providers) will be necessary to properly implement and govern this important technical and cultural transition.