In Italy several pilot HPV screening programs started between 2011-2012 in early 2013 and provided guidelines for its application (stand-alone HPV testing by validated methods, cytological triage of HPV positives, beginning at age 30-35, 5-year intervals). The results of second round of HPV screening will be presented
In 2012, 19 Italian organized cervical screening programmes from 10 regional programmes invited 311,856 women for HPV-based screening; 41.5% complied, with a decreasing North-South trend. All programs applied a cytology triage algorithm, re-inviting HPV+/cytology- women after one year to repeat HPV test.. Here we present HPV positivity, cytology triage results referral rate and detection rate at baseline and in the second round of screening (after 3 years).
The prevalence of HPV in the first round varies in different regions Italian while in the second round the percentage of HPV positivity is much more similar in various places; however, the positivity in the second round decreases by about 50% as well as the recall rate . CIN2+ detection rate in HPV+/cytology+ women ranged from 0.4/1000 to 0.8/1000 compared to a 6.5/1000-8.3/1000 range in first round.
Referral rate to colposcopy strongly reduced compared to first round ( and lower than with cytology), therefore extra cost and anxiety for women limited to 1° round with HPV. Probability of carrying CIN2+ among HPV+ women strongly reduced after the first round of HPV screening. The DR total decreases for two reasons: there are fewer infections and why women with new infections still have a low number of lesions because the persistence of infection is for a few years, while at the first screening round are infections that are present from any years.
If there are fewer lesions in new infections in the second round you can change the triage strategies, much less aggressive or longer repeat interval.Effects expected (reduced) also with 5 year intervals HPV test positivity .