The human papillomavirus Test of Cure: A lesson on compliance with the NHMRC guidelines on screening to prevent cervical cancer

A. Munro, K. Spilsbury, Yee Leung, P. O'Leary, V. Williams, J. Codde, N. Steel, Paul Cohen, J. Semmens

    Research output: Contribution to journalArticle

    Abstract

    © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Background In Australia, high-risk human papillomavirus (HR HPV) testing is recommended for follow-up of women treated for a high-grade squamous intra-epithelial lesion (HSIL). The sensitivity of HR HPV testing is critical to identify women at risk of further high-grade cervical disease. In Australia, this management protocol is known as the 'Test of Cure' (ToC). Aim To conduct a population-based study investigating practitioners' compliance with ToC. Materials and Methods Women treated for an HSIL between the five-year period 01 Jan 2006 to 31 Dec 2010 were identified and followed up for at least a 27-month period. Proportions and relative odds were determined for women entering and completing the ToC management pathway within recommended time frames. Results There were 5,194 women identified as 'eligible' to enter the ToC management pathway. Of these, 1,916 (37%) were managed with annual Pap smears and never had a HR HPV test performed. There were 1,296 (25%) women who entered the ToC management pathway within recommended time frames, and a further 1,978 (38%) women entered outside of the recommended time frames. Overall, 961 women completed the ToC and were classified as 'cured' and were eligible to return to two-yearly Pap smears. Women's demographic information was significantly associated with ToC commencement, specifically, age and year of treatment, and Index of Relative Socioeconomic Disadvantage. Conclusion Overall, a significant number of Australian women did not enter (∼37%) and complete (∼50%) the ToC management pathway. The challenge remains to advocate its use to practitioners to ensure women are returned to the population screening interval in a timely manner.
    Original languageEnglish
    Pages (from-to)185-190
    JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
    Volume55
    Issue number2
    DOIs
    Publication statusPublished - 2015

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    Uterine Cervical Neoplasms
    Guidelines
    Papanicolaou Test
    New Zealand
    Population
    Odds Ratio
    Demography

    Cite this

    @article{ed005af144fe475d9c67bd809ecf886d,
    title = "The human papillomavirus Test of Cure: A lesson on compliance with the NHMRC guidelines on screening to prevent cervical cancer",
    abstract = "{\circledC} 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Background In Australia, high-risk human papillomavirus (HR HPV) testing is recommended for follow-up of women treated for a high-grade squamous intra-epithelial lesion (HSIL). The sensitivity of HR HPV testing is critical to identify women at risk of further high-grade cervical disease. In Australia, this management protocol is known as the 'Test of Cure' (ToC). Aim To conduct a population-based study investigating practitioners' compliance with ToC. Materials and Methods Women treated for an HSIL between the five-year period 01 Jan 2006 to 31 Dec 2010 were identified and followed up for at least a 27-month period. Proportions and relative odds were determined for women entering and completing the ToC management pathway within recommended time frames. Results There were 5,194 women identified as 'eligible' to enter the ToC management pathway. Of these, 1,916 (37{\%}) were managed with annual Pap smears and never had a HR HPV test performed. There were 1,296 (25{\%}) women who entered the ToC management pathway within recommended time frames, and a further 1,978 (38{\%}) women entered outside of the recommended time frames. Overall, 961 women completed the ToC and were classified as 'cured' and were eligible to return to two-yearly Pap smears. Women's demographic information was significantly associated with ToC commencement, specifically, age and year of treatment, and Index of Relative Socioeconomic Disadvantage. Conclusion Overall, a significant number of Australian women did not enter (∼37{\%}) and complete (∼50{\%}) the ToC management pathway. The challenge remains to advocate its use to practitioners to ensure women are returned to the population screening interval in a timely manner.",
    author = "A. Munro and K. Spilsbury and Yee Leung and P. O'Leary and V. Williams and J. Codde and N. Steel and Paul Cohen and J. Semmens",
    year = "2015",
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    pages = "185--190",
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    The human papillomavirus Test of Cure: A lesson on compliance with the NHMRC guidelines on screening to prevent cervical cancer. / Munro, A.; Spilsbury, K.; Leung, Yee; O'Leary, P.; Williams, V.; Codde, J.; Steel, N.; Cohen, Paul; Semmens, J.

    In: Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol. 55, No. 2, 2015, p. 185-190.

    Research output: Contribution to journalArticle

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    T1 - The human papillomavirus Test of Cure: A lesson on compliance with the NHMRC guidelines on screening to prevent cervical cancer

    AU - Munro, A.

    AU - Spilsbury, K.

    AU - Leung, Yee

    AU - O'Leary, P.

    AU - Williams, V.

    AU - Codde, J.

    AU - Steel, N.

    AU - Cohen, Paul

    AU - Semmens, J.

    PY - 2015

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    N2 - © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Background In Australia, high-risk human papillomavirus (HR HPV) testing is recommended for follow-up of women treated for a high-grade squamous intra-epithelial lesion (HSIL). The sensitivity of HR HPV testing is critical to identify women at risk of further high-grade cervical disease. In Australia, this management protocol is known as the 'Test of Cure' (ToC). Aim To conduct a population-based study investigating practitioners' compliance with ToC. Materials and Methods Women treated for an HSIL between the five-year period 01 Jan 2006 to 31 Dec 2010 were identified and followed up for at least a 27-month period. Proportions and relative odds were determined for women entering and completing the ToC management pathway within recommended time frames. Results There were 5,194 women identified as 'eligible' to enter the ToC management pathway. Of these, 1,916 (37%) were managed with annual Pap smears and never had a HR HPV test performed. There were 1,296 (25%) women who entered the ToC management pathway within recommended time frames, and a further 1,978 (38%) women entered outside of the recommended time frames. Overall, 961 women completed the ToC and were classified as 'cured' and were eligible to return to two-yearly Pap smears. Women's demographic information was significantly associated with ToC commencement, specifically, age and year of treatment, and Index of Relative Socioeconomic Disadvantage. Conclusion Overall, a significant number of Australian women did not enter (∼37%) and complete (∼50%) the ToC management pathway. The challenge remains to advocate its use to practitioners to ensure women are returned to the population screening interval in a timely manner.

    AB - © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Background In Australia, high-risk human papillomavirus (HR HPV) testing is recommended for follow-up of women treated for a high-grade squamous intra-epithelial lesion (HSIL). The sensitivity of HR HPV testing is critical to identify women at risk of further high-grade cervical disease. In Australia, this management protocol is known as the 'Test of Cure' (ToC). Aim To conduct a population-based study investigating practitioners' compliance with ToC. Materials and Methods Women treated for an HSIL between the five-year period 01 Jan 2006 to 31 Dec 2010 were identified and followed up for at least a 27-month period. Proportions and relative odds were determined for women entering and completing the ToC management pathway within recommended time frames. Results There were 5,194 women identified as 'eligible' to enter the ToC management pathway. Of these, 1,916 (37%) were managed with annual Pap smears and never had a HR HPV test performed. There were 1,296 (25%) women who entered the ToC management pathway within recommended time frames, and a further 1,978 (38%) women entered outside of the recommended time frames. Overall, 961 women completed the ToC and were classified as 'cured' and were eligible to return to two-yearly Pap smears. Women's demographic information was significantly associated with ToC commencement, specifically, age and year of treatment, and Index of Relative Socioeconomic Disadvantage. Conclusion Overall, a significant number of Australian women did not enter (∼37%) and complete (∼50%) the ToC management pathway. The challenge remains to advocate its use to practitioners to ensure women are returned to the population screening interval in a timely manner.

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