The human papillomavirus T est of C ure: A lesson on compliance with the NHMRC guidelines on screening to prevent cervical cancer

Background In A ustralia, high‐risk human papillomavirus ( HR HPV ) testing is recommended for follow‐up of women treated for a high‐grade squamous intra‐epithelial lesion ( HSIL ). The sensitivity of HR HPV testing is critical to identify women at risk of further high‐grade cervical disease. In A ustralia, this management protocol is known as the ‘ T est of C ure’ ( T o C ). Aim To conduct a population‐based study investigating practitioners' compliance with T o C . Materials and Methods Women treated for an HSIL between the five‐year period 01 J an 2006 to 31 D ec 2010 were identified and followed up for at least a 27‐month period. Proportions and relative odds were determined for women entering and completing the T o C management pathway within recommended time frames. Results There were 5,194 women identified as ‘eligible’ to enter the T o C management pathway. Of these, 1,916 (37%) were managed with annual P ap smears and never had a HR HPV test performed. There were 1,296 (25%) women who entered the T o C management pathway within recommended time frames, and a further 1,978 (38%) women entered outside of the recommended time frames. Overall, 961 women completed the T o C and were classified as ‘cured’ and were eligible to return to two‐yearly P ap smears. Women's demographic information was significantly associated with T o C commencement, specifically, age and year of treatment, and I ndex of R elative S ocioeconomic D isadvantage. Conclusion Overall, a significant number of A ustralian women did not enter (~37%) and complete (~50%) the T o C management pathway. The challenge remains to advocate its use to practitioners to ensure women are returned to the population screening interval in a timely manner.