HPV detection-based cervical XXXX screening program in low-resource setting: lessons learnt from a community-based demonstration project in India.

@entity5 @entity1 @entity14043
PURPOSE: A demonstration project was conducted to assess feasibility of implementing HPV detection-based cervical @entity5 screening in primary care settings in India and to generate local evidence on feasibility and effectiveness of HPV detection in primary screening. METHODS: The project was implemented by setting up screening clinics at primary health centers. Eligible @entity1 were screened by HPV DNA test (Hybrid capture 2). All samples were processed and tested in a single laboratory. Colposcopy services were provided to screen-positive @entity1 at the same community clinics. Project utilized services of community health workers for community mobilization, recall of screen-positive and disease-positive @entity1 . @entity1 with >= CIN2 diagnosis were treated at tertiary hospital. RESULTS: Totally, 44,110 @entity1 were screened and HPV positivity was 4.7  %. Compliance to recall of @entity14043 -positive @entity1 for colposcopy was 78  %. Detection rate of CIN3+ by HPV test was 3.9/1,000 @entity1 . Compliance of @entity1 to treatment was 80.1  %. However, compliance of HPV-positive @entity1 for follow-up at 1  year was poor (23.2  %). Concurrent use of VIA to screen the @entity1 did not have any advantage but increased number of unnecessary colposcopies and biopsies. CONCLUSIONS: Our project demonstrated that it was possible to implement HPV detection-based screening using existing primary healthcare infrastructure. Performing colposcopy at primary setting is feasible, improves compliance and reduces over-treatment. In settings with low to moderately high HPV prevalence, direct referral of HPV-positive @entity1 is advisable. Community health workers can be effectively used for recalling the positive @entity1 .
