Key Features of HPV Testing Practice: A review of reviews

Anis Syakira Jailani, Nur Zahirah Balqis-Ali, Yuke-Lin Kong, Lee Ching Wann, Woon Wei Lin, Fun Weng Hong, Sondi Sararaks, Nor Shazimah Abdul Samad, Wan Mohd Shariffuddin Zainuddin, Zakiah Mohd Said: Key Features of HPV Testing Practice: A review of reviews. published online at https://apcph.cphm.my, 2022, (Type: POSTER PRESENTATION; Organisation: Institute for Health Systems Research, National Institutes of Health; Adult Health Sector, Family Health Development Division).

Abstract

Introduction: The World Health Organisation 's global strategy for cervical cancer elimination advocates for 70% of eligible women to be screened for cervical cancer by the age of 35, and again by the age of 45, using a high-performance test. Human Papillomavirus (HPV) sampling performed by healthcare providers or through self-sampling is recommended as the primary screening method with high effectiveness to detect high risk HPV which can cause cervical cancer. The screening rate in Malaysia remains low at around 25% yearly. The Ministry of Health (MOH) aims to employ HPV sampling as the primary screening method by 2023. To assist policymakers, we aimed to identify the key features of HPV sampling practice to improve screening uptake.
Methods: We performed a systematic literature search to identify effective practices of HPV testing. The search covered English-language articles from PubMed and Ovid Medline databases from January 2000 to March 2022. Only systematic review and meta-analysis articles were included for extraction. The title and abstract screening process was performed by two independent reviewers. The same method was applied for full-text screening and data extraction. Disagreements were resolved through consensus. No quality assessment was conducted on the articles retrieved. A narrative synthesis was performed on the included articles. The extracted information includes the method used for HPV testing found effective in increasing screening uptake, target population and place or setting where the practices were conducted.
Results: We found three systematic reviews, including one meta-analysis article that discussed the screening uptake through HPV testing practices. Seven HPV testing practices were found to improve screening uptake. The key features of the practices were i) having an education component, ii) employment of invitation methods, and iii) integration with other programmes. Some practices had a combination of these features. Most practices provided information sheets in their intervention packages to promote education. Invitation methods were categorised into three practices; i) mail-to-all (self-sampling kits were mailed directly to the targeted population 's home address), ii) opt-in (women who agreed to participate were sent self-sampling kits), iii) door-to-door (community workers delivered self-sampling kits to homes or workplaces). Integration of cervical cancer screening during HPV vaccination programmes or combined approach with other types of cancer screenings were unique practices found. We also found more practices were enrolled in a home setting (3 practices), while the rest were either in the community (1 practice), school (2 practices), or workplace (1 practice). Discussion and Conclusion: This review summarises the key features of HPV testing practice that were effective in improving screening uptake. Information provision to educate and/or sensitise participants on HPV testing appeared to be a common strategy used in recruitment, as education is an established prerequisite to screening programmes. Sending out invitations to encourage women in participating screening activities is vital but should be accompanied by a proper database and tracking system to ensure a smooth follow-up. Innovative strategies such as integration with existing resources/programmes could be an effective option for policymakers to consider.

BibTeX (Download)

@proceedings{APCPH2022-P-66,
title = {Key Features of HPV Testing Practice: A review of reviews},
author = {Anis Syakira Jailani and Nur Zahirah Balqis-Ali and Yuke-Lin Kong and Lee Ching Wann and Woon Wei Lin and Fun Weng Hong and Sondi Sararaks and Nor Shazimah Abdul Samad and Wan Mohd Shariffuddin Zainuddin and Zakiah Mohd Said},
url = {https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-P-66.pdf 
 
https://apcph.cphm.my/wp-content/uploads/wpforms/1176-1e04940bb5d885bf8711ed19095a89ed/poster_cervicalca_final_250722-6c8da880e10a40944fd3004024174d5e.pdf},
year  = {2022},
date = {2022-08-02},
urldate = {2022-08-02},
issue = {7},
abstract = {Introduction: The World Health Organisation 's global strategy for cervical cancer elimination advocates for 70% of eligible women to be screened for cervical cancer by the age of 35, and again by the age of 45, using a high-performance test. Human Papillomavirus (HPV) sampling performed by healthcare providers or through self-sampling is recommended as the primary screening method with high effectiveness to detect high risk HPV which can cause cervical cancer. The screening rate in Malaysia remains low at around 25% yearly. The Ministry of Health (MOH) aims to employ HPV sampling as the primary screening method by 2023. To assist policymakers, we aimed to identify the key features of HPV sampling practice to improve screening uptake. 
Methods: We performed a systematic literature search to identify effective practices of HPV testing. The search covered English-language articles from PubMed and Ovid Medline databases from January 2000 to March 2022. Only systematic review and meta-analysis articles were included for extraction. The title and abstract screening process was performed by two independent reviewers. The same method was applied for full-text screening and data extraction. Disagreements were resolved through consensus. No quality assessment was conducted on the articles retrieved. A narrative synthesis was performed on the included articles. The extracted information includes the method used for HPV testing found effective in increasing screening uptake, target population and place or setting where the practices were conducted. 
Results: We found three systematic reviews, including one meta-analysis article that discussed the screening uptake through HPV testing practices. Seven HPV testing practices were found to improve screening uptake. The key features of the practices were i) having an education component, ii) employment of invitation methods, and iii) integration with other programmes. Some practices had a combination of these features. Most practices provided information sheets in their intervention packages to promote education. Invitation methods were categorised into three practices; i) mail-to-all (self-sampling kits were mailed directly to the targeted population 's home address), ii) opt-in (women who agreed to participate were sent self-sampling kits), iii) door-to-door (community workers delivered self-sampling kits to homes or workplaces). Integration of cervical cancer screening during HPV vaccination programmes or combined approach with other types of cancer screenings were unique practices found. We also found more practices were enrolled in a home setting (3 practices), while the rest were either in the community (1 practice), school (2 practices), or workplace (1 practice). Discussion and Conclusion: This review summarises the key features of HPV testing practice that were effective in improving screening uptake. Information provision to educate and/or sensitise participants on HPV testing appeared to be a common strategy used in recruitment, as education is an established prerequisite to screening programmes. Sending out invitations to encourage women in participating screening activities is vital but should be accompanied by a proper database and tracking system to ensure a smooth follow-up. Innovative strategies such as integration with existing resources/programmes could be an effective option for policymakers to consider.},
howpublished = {published online at https://apcph.cphm.my},
note = {Type: POSTER PRESENTATION; Organisation: Institute for Health Systems Research, National Institutes of Health; Adult Health Sector, Family Health Development Division},
keywords = {cervical cancer, HPV, screening, self-sampling},
pubstate = {published},
tppubtype = {proceedings}
}