Implementing the 3T-approach for cervical cancer screening in Cameroon: Preliminary results on program performance.
Implementing the 3T-approach for cervical cancer screening in Cameroon: Preliminary results on program performance.
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DOI：
10.1002/cam4.3355
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发表时间：
2020-10
期刊：
影响因子：
4
通讯作者：
Petignat P
中科院分区：
文献类型：
--
作者：
Levy J;de Preux M;Kenfack B;Sormani J;Catarino R;Tincho EF;Frund C;Fouogue JT;Vassilakos P;Petignat P
世界卫生组织 (WHO) 推荐的选项包括人乳头瘤病毒 (HPV) 初步筛查，然后用醋酸 (VIA) 分类进行目视检查。我们实施了一个基于 3T 方法（测试分类和治疗）的计划。我们的目标是通过定义一组绩效指数来验证该计划的有效性。在 Dschang（喀麦隆）开展了一场宣传活动，邀请 30-49 岁的女性参加基于 3T 方法的筛查。参与者进行 HPV 自我采样 (Self-HPV)，使用护理点 Xpert HPV 检测进行分析，然后根据需要进行 VIA/VILI 分类和治疗。定义了筛查、诊断、治疗和随访的关键绩效指标（KPI），并描述了该方法可能以最佳方式运行的可实现目标。共有 840 名女性参与，平均年龄为 39.4±5.9 岁。 KPI 包括 (i) 筛查率（7 个月时为 8.4%，12 个月时目标 =20%），(ii) HPV 阳性率（19.8%，预期范围 18‐25%），(iii) 转诊至 VIA/VILI 并完成测试的依从性（100%，目标 >90%），(iv) 转诊至热消融的依从性（100%，目标 >90%），(v) VIA/VILI 阳性率（50.6%，预期范围 45-55%），（vi）从诊断到治疗的单次就诊（79.8%，目标 >80%），（vii）1 个月随访依从性（96.4%，目标 >80%）和（viii）6 个月随访依从性（70.6%，目标 >80%）。基于单次访问 3T 方法的项目绩效与既定目标相对应，初步结果支持定期监控 KPI 的充分性。该研究显示了低收入国家使用 3T 策略进行测试分类和治疗的单次宫颈癌筛查的表现。我们的结果将引起人们极大的兴趣，特别是那些在低收入国家设计和实施女性健康筛查项目的人。改进初级筛查、诊断、治疗和随访，例如喀麦隆采用单次就诊 3T 方法筛查宫颈癌，将大大降低低收入和中等收入国家可预防或可治疗疾病的发病率。
Option recommended by World Health Organization (WHO) includes human papillomavirus (HPV) primary screening followed by visual inspection with acetic acid (VIA) triage. We implemented a program based on a 3T‐approach (Test‐Triage and Treat). Our objective was to verify the effectiveness of the program by defining a set of performance indices. A sensitization campaign was performed in Dschang (Cameroon) and women aged 30‐49 years were invited to participate for screening based on the 3T‐approach. Participants performed HPV self‐sampling (Self‐HPV), analyzed with the point‐of‐care Xpert HPV assay followed by VIA/VILI triage and treatment if required. Key performance indicators (KPIs) for screening, diagnosis, treatment and follow‐up were defined, and achievable targets were described for which the approach is likely to be running optimally. A total of 840 women with a mean age of 39.4±5.9 years participated. The KPIs included (i) the screening rate (8.4% at 7 months, target =20% at 12 months), (ii) HPV positivity rate (19.8%, expected range 18‐25%), (iii) compliance to referral to VIA/VILI and complete test (100%, target >90%), (iv) compliance to referral to thermal ablation (100%, target >90%), (v) VIA/VILI positivity rate (50.6%, expected range 45‐55%), (vi) a single visit from diagnostic to treatment (79.8%, target >80%), (vii) compliance to follow‐up at 1 month (96.4%, target >80%) and (viii) at 6 months (70.6%, target >80%). Program performance based on the single‐visit 3T‐approach corresponded to defined targets and preliminary results support adequateness of KPIs for periodic monitoring. The study shows the performance of screening for cervical cancer in a single visit, using the 3T strategy, for Test‐Triage and Treat in low‐income countries Our results will be of great interest especially those designing and conducting women’s health screening programs in low‐income countries. Improved primary screening, diagnosis, treatment, and follow‐up, such as in the single‐visit 3T approach to screen cervical cancer in Cameroon, will substantially reduce the incidence of preventable or treatable diseases in low‐ and middle‐income countries.
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影响因子：
2.3
作者：
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通讯作者：
Parham, Groesbeck P.