HPV self-testing for primary cervical cancer screening in Madagascar: VIA/VILI triage compliance in HPV-positive women

• DOI: 10.1371/journal.pone.0220632
• Publication Date: 2019-08-13T17:28:52Z
• Authors: Anne-Caroline Benski; Manuela Viviano; Jéromine Jinoro; Milena Alec; Rosa Catarino; Joséa Herniainasolo; Pierre Vassilakos; Patrick Petignat
• Keywords: Triage

Objective To assess triage compliance and the effect of time from screening to on follow-up among HPV-positive women. Methods We recruited 1232 women in a campaign Madagascar February October 2015. In first period (February–May), HPV tests were performed remotely using cobas test. second (May–October), testing was on-site Xpert assay. invited for with visual inspection acetic acid (VIA) Lugol's iodine (VILI). Systematic biopsy endocervical brushing all quality control. Three groups defined according invitation women—Group I: delayed (> 3 months), Group II: prompt (24–48 hours), III: immediate (< 24 hours). Results A total self-sampled study (496 I, 512 II, 224 III). Participants' mean age 43.2 ± 9.3 years. Mean VIA/VILI 103.5 43.6 days. Overall prevalence 28.0%. 27.2% I (cobas test), 29.2% 2 (Xpert 26,7% III test). The rate 77.8% 82.7% 95.0% III. Of undergoing VIA/VILI, 56.3% 43.5% Groups II/III had positive results. Prevalence cervical intraepithelial neoplasia grade or worse 9.8% 6.8% II/III. Non-adherence higher rural women, uneducated I. Conclusion best compliance. single-day test strategy is preferred low-resource settings.