Joseph A. Lucci (United States of America)

University Of Texas. Medical School OBGYN

Presenter of 1 Presentation

Public Health / Epidemiology / Screening for HPV-related Disease: Implementation, Evaluation and Impact ePoster

IMPROVING CERVICAL CANCER PREVENTION SCREENING AMONG MEDICALLY-UNDERSERVED WOMEN. A COMMUNITY BASE PROGRAM. A PILOT STUDY. (ID 114)

Session Date
07/21/2020
Session Time
10:00 - 17:00
Room
ePoster
Session Type
Poster Viewing - 20-24 July
Session Name
Public Health / Epidemiology / Screening for HPV-related Disease: Implementation, Evaluation and Impact
Lecture Time
10:32 - 10:33

Abstract

Introduction

Our community is comprised of over 6 million people that is very diverse economically, culturally, ethnically and educationally. Twenty-nine percent are foreign born, 22% have not completed high school, 21% live in poverty, 22-26% do not have health insurance and another 400,000 are undocumented immigrants. The purpose of this study was to optimize the cost efficacy of cervical cancer screening in this population through incorporating HPV DNA (DNA) Testing (Cobas) and mRNA (RNA) testing (APTIMA) by reducing the need for diagnostic and therapeutic interventions and increasing the screening interval.

Methods

We partnered with clinics in communities of greatest need to provide cervical cancer screening. Screening consisted of a pelvic exam and pap test. Subsequently HPV mRNA testing was added in April 2019 and DNA testing in August 2019. We evaluated the frequency of diagnostic and therapeutic interventions as a result of the incorporation of HPV testing.

Results

Between 2012 and April 2019, 1606 screening exams with pap were performed with 10.2% abnormal, all of which underwent colposcopy, 50% were treated with LEEP, and 50% required repeat pap. In June 2019, 85 screening exams were performed with pap and RNA. 10.6% of paps were abnormal, 2 of 6 ASCUS paps had RNA, 4 cytologically negative paps had RNA and 2 of 7 unsatisfactory paps had RNA. 3 patients underwent colposcopy with 1 LEEP. In August 2019, 154 screening exams were performed with 12 (7.8%) abnormal paps, 3 had both DNA and RNA, one had RNA only. Twelve had normal paps with DNA of which 8 had RNA. Only 4 (33%) underwent colposcopy and none required LEEP.

Conclusions

The incorporation of HPV mRNA and DNA testing has decreased the frequency of therapeutic interventions in our patient population and allowed for an increase in screening interval to 5 years in 81.6% of our patients.

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