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Acting on the call for cervical cancer elimination: Planning tools for low- and middle- income countries to increase the coverage and effectiveness of screening and treatment.
Herrick, Tara; Thomson, Kerry A; Shin, Michelle; Gannon, Sarah; Tsu, Vivien; de Sanjosé, Silvia.
Afiliación
  • Herrick T; Market Dynamics, PATH, 2201, Westlake Ave Suite 200, Seattle, WA, 98121, USA. therrick@path.org.
  • Thomson KA; Sexual and Reproductive Health Program, PATH, 2201 Westlake Ave, Suite 200, Seattle, WA, 98121, USA. thomsonk@uw.edu.
  • Shin M; Department of Global Health, University of Washington, Seattle, USA.
  • Gannon S; Market Dynamics, PATH, 2201, Westlake Ave Suite 200, Seattle, WA, 98121, USA.
  • Tsu V; Department of Global Health, University of Washington, Seattle, USA.
  • de Sanjosé S; Sexual and Reproductive Health Program, PATH, 2201 Westlake Ave, Suite 200, Seattle, WA, 98121, USA.
BMC Health Serv Res ; 22(1): 1246, 2022 Oct 14.
Article en En | MEDLINE | ID: mdl-36241993
INTRODUCTION: Accessible planning tools tailored for low-and middle-income countries can assist decision makers in comparing implementation of different cervical cancer screening approaches and treatment delivery scenarios in settings with high cervical cancer burden. METHODS: The Cervical Precancer Planning Tool (CPPT) was developed by PATH for users to explore and compare the accuracy of screening approaches, what treatment equipment to procure, and how best to deploy treatment equipment in a given country. The CPPT compares four screening approaches: 1) visual inspection with acetic acid (VIA), 2) HPV testing, 3) HPV testing followed by a VIA triage, and 4) HPV testing followed by an enhanced triage test. Accuracy of screening outcomes (e.g., true positives, false positives) is based on published sensitivity and specificity of tests to detect cervical precancerous lesions. The CPPT compares five scenarios for deploying ablative treatment equipment: 1) cervical precancer equipment at every location a woman is screened (single visit approach), 2) equipment only at a hospital level, 3) a single unit of equipment in each district, 4) allowing two districts to share a single unit of equipment, and 5) equipment placed at select district hospitals paired with mobile outreach. Users can customize the CPPT by adjusting pre-populated baseline values and assumptions, including population estimates, screening age range, screening frequency, HPV and HIV prevalence, supply costs, and health facility details. RESULTS: The CPPT generates data tables and graphs that compare the results of implementing each of the four screening and five treatment scenarios disaggregated by HIV status. Outputs include the number and outcomes of women screened, cost of each screening approach, provider time and cost saved by implementing self-sampling for HPV testing, number of women treated, treatment equipment needed by type, and the financial and economic costs for each equipment deployment scenario. CONCLUSION: The CPPT provides practical information and data to compare tradeoffs of patient access and screening accuracy as well as efficient utilization of equipment, skilled personnel, and financial resources. Country decision makers can use outputs from the CPPT to guide the scale-up of cervical cancer screening and treatment while optimizing limited resources.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Neoplasias del Cuello Uterino / Infecciones por Papillomavirus Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Female / Humans Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Neoplasias del Cuello Uterino / Infecciones por Papillomavirus Tipo de estudio: Diagnostic_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Female / Humans Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido