HPV self-sampling and follow-up over two rounds of cervical screening in Australia - the iPap trial.

Objectives: Previously, based on 6 months of follow-up, we showed that HPV self-sampling improved participation in cervical screening compared to a reminder letter for Pap testing for never- and under-screened women. Here, we report follow-up and related screening outcomes for women who participated in the initial self-sampling over two screening rounds.

Setting: The randomised controlled trial was conducted in Australia.

Pathways to a cancer-free future: A protocol for modelled evaluations to maximize the future impact of interventions on cervical cancer in Australia.

Objective: Australia's HPV vaccination and HPV-based cervical screening programs are changing the landscape in cervical cancer prevention. We aim to identify areas which can make the biggest further impact on cervical cancer burden. This protocol describes the first stage of a program of work called Pathways-Cervix that aims to generate evidence from modelled evaluations of interventions across the cervical cancer spectrum.

Protocol for Compass: a randomised controlled trial of primary HPV testing versus cytology screening for cervical cancer in HPV-unvaccinated and vaccinated women aged 25-69 years living in Australia.

Introduction: Australia's National Cervical Screening Program (NCSP) currently recommends 2-year cytology in women aged 18-69 years. Following a review of the NCSP prompted by the implementation of human papillomavirus (HPV) vaccination, the programme will transition in 2017 to 5-year primary HPV screening with partial genotyping for HPV16/18 in women aged 25-74 years. Compass is a sentinel experience for the renewed NCSP and the first prospectively randomised trial of primary HPV screening compared with cytology to be conducted in a population with high uptake of HPV vaccination.

Cervical screening with primary HPV testing or cytology in a population of women in which those aged 33 years or younger had previously been offered HPV vaccination: Results of the Compass pilot randomised trial.

Background: Using primary human papillomavirus (HPV) testing for cervical screening increases detection of high-grade cervical intraepithelial neoplastic lesions and invasive cancer (cervical intraepithelial neoplasia grade 2+ [CIN2+]) compared to cytology, but no evaluation has been conducted in a population previously offered HPV vaccination. We aimed to assess colposcopy referral and CIN2+ detection rates for HPV-screened versus cytology-screened women in Australia's HPV-vaccinated population (by 2014, resident women ≤33 years had been age-eligible for HPV vaccination, with 3-dose uptake across age cohorts being about 50%-77%).

Methods And Findings: Compass is an open-label randomised trial of 5-yearly HPV screening versus 2.

HAVE YOU HAD THE HPV VACCINE? YOU STILL NEED TO BE SCREENED FOR CERVICAL CANCER.

Nearly all cervical cancer is caused by one or more oncogenic strain of Human Papilloma Virus (HPV) (Walboomers et al. 1999). There are about 40 anogenital HPV types and approximately 15 are associated with cancer of the cervix.

Home-based HPV self-sampling improves participation by never-screened and under-screened women: Results from a large randomized trial (iPap) in Australia.

We conducted a randomized controlled trial to determine whether HPV self-sampling increases participation in cervical screening by never- and under-screened (not screened in past 5 years) women when compared with a reminder letter for a Pap test. Never- or under-screened Victorian women aged 30-69 years, not pregnant and with no prior hysterectomy were eligible. Within each stratum (never-screened and under-screened), we randomly allocated 7,140 women to self-sampling and 1,020 to Pap test reminders.

Women's experience with home-based self-sampling for human papillomavirus testing.

Background: Increasing cervical screening coverage by reaching inadequately screened groups is essential for improving the effectiveness of cervical screening programs. Offering HPV self-sampling to women who are never or under-screened can improve screening participation, however participation varies widely between settings. Information on women's experience with self-sampling and preferences for future self-sampling screening is essential for programs to optimize participation.

A pilot study to compare dry cervical sample collection with standard practice of wet cervical samples for human papillomavirus testing.

Background: For human papillomavirus (HPV) DNA detection, specimen collection and transportation using a dry swab without transport medium has advantages, in various situations, over liquid media.

Objective: In this pilot study we evaluated whether a dry cervical sample taken with a flocked swab (dry sample) is a valid alternative for HPV DNA testing compared with the standard practice of a wet sample taken with a cyto-broom placed directly into liquid media (wet sample).

Study Design: Women attending the dysplasia clinic at the Royal Women's Hospital, Melbourne Australia between November 2013 and February 2014 were enrolled.

Women's views on human papillomavirus self-sampling: focus groups to assess acceptability, invitation letters and a test kit in the Australian setting.

Unlabelled: Background The study evaluated acceptability, invitation letters and the test kit for a trial of human papillomavirus (HPV) self-sampling among never- and under-screened women in Australia.

Methods: Victorian women, 30-69 years, who had never had a Pap test or were overdue for one, participated. Four focus groups including eight to nine participants segmented by age (30-49 and 50-69 years) and screening history (never- and under-screened) were conducted in August 2013.

Rationale and design of the iPap trial: a randomized controlled trial of home-based HPV self-sampling for improving participation in cervical screening by never- and under-screened women in Australia.

Background: Organized screening based on Pap tests has substantially reduced deaths from cervical cancer in many countries, including Australia. However, the impact of the program depends upon the degree to which women participate. A new method of screening, testing for human papillomavirus (HPV) DNA to detect the virus that causes cervical cancer, has recently become available.

HPV testing in the National Cervical Screening Program--when is it recommended?

Background: Women with high grade cervical squamous intraepithelial lesions (HSILs) have traditionally had annual smears after treatment. This recommendation however, changed in 2005. Since then, testing for high risk types of human papillomavirus (HPV) has been an integral part of the follow up of these women.

Abnormal Pap tests after the HPV vaccine.

Background: Worldwide, cervical cancer affects 500 000 women and causes 275 000 deaths annually. Persistent infection with one of 13 oncogenic types of human papillomavirus (HPV) is now known to be the cause of both squamous and adenocervical carcinomas of the cervix. The Pap test involves the examination of exfoliated cells from the cervix and has been shown to be an effective way of detecting the precursors of squamous cell carcinoma.

The incidence of genital warts in Australian women prior to the national vaccination program.

The quadrivalent human papillomavirus (HPV) vaccine currently being delivered to Australian women aged 12-26 years under the National HPV Vaccination Program promises to substantially reduce the incidence of genital warts. We review what is known about the burden of genital warts among Australian women. Incidence appears to peak among women aged 20-24 years, of whom 1.

Pap test update.

Background: 2006 was an eventful year in the area of screening to prevent cervical cancer. New screening guidelines were introduced nationally in July, and in November the Australian Government agreed to fund one of the human papillomavirus (HPV) vaccines, Gardasil, under the National Immunisation Program.

Objective: This article discusses the cervical screening program and the Pap test in the era of HPV vaccination.

Human papillomavirus: beware the infection you can't see.

Background: Genital human papillomavirus (HPV) is a common sexually transmitted infection. In the first 10 years of sexual activity, point prevalence rates approach 25% and the lifetime risk of acquisition of this infection may be as high as 80%. There are over 200 types of HPV, of which approximately 50 infect the genital area.