HPV prevalence and risk of pre-cancer and cancer in regular immigrants in Italy: results from HPV DNA test-based screening pilot programsReport as inadecuate




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Infectious Agents and Cancer

, 10:14

First Online: 07 May 2015Received: 20 February 2015Accepted: 21 April 2015DOI: 10.1186-s13027-015-0009-x

Cite this article as: Campari, C., Fedato, C., Petrelli, A. et al. Infect Agents Cancer 2015 10: 14. doi:10.1186-s13027-015-0009-x

Abstract

ᅟImmigrants from low- and medium-income countries have a higher risk of cervical cancer due both to barriers in access to screening and to higher human papillomavirus HPV prevalence.

In the near future many screening programmes in industrialised countries will replace Pap test with HPV as primary test. In order to plan future interventions, it is essential to understand how the HPV screening performs in immigrant women.

MethodsWe conducted a survey on the main performance indicators from some of the HPV DNA-based pilot programmes in Italy, comparing regular immigrant women, identified as women resident in Italy who were born abroad, with women who were born in Italy. All the programmes applied the same protocol, with HPV as stand-alone test starting for women of 25 or 35 to 64 years of age. Cytology triage is performed for positive women; those ASC-US or more severe are referred directly to colposcopy; negative women are referred to repeat HPV after one year.

ResultsOverall, 162,829 women were invited, of whom 22,814 were born abroad. Participation was higher for Italy-born than born abroad 52.2% vs. 43.6%, particularly for women over 45 years. HPV positivity rate was higher in immigrants: 7.8% vs. 6.1%, age-adjusted Relative Risk age-adj RR 1.18, 95% confidence interval 95% CI 1.13-1.22. The proportion of women with positive cytology triage was similar in the two groups 42%. Cervical Intraepithelial Neoplasia CIN grade 2 or more severe detection rate was higher for born abroad age-adj RR 1.65, 95% CI 1.45-1.89. The difference was stronger when considering only CIN3 or more severe age-adj RR 2.29, 95% CI 1.90-2.75. Both HPV positivity and CIN2 or more severe detection rate had a different age curve in born abroad compared with Italy-born: in the former, the risk was almost flat, while in the latter it declined rapidly with age.

ConclusionCompliance with HPV screening is lower for migrant women, who are affected by higher HPV positivity and CIN3 cancer detection rates.

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Author: Cinzia Campari - Chiara Fedato - Alessio Petrelli - Manuel Zorzi - Carla Cogo - Adele Caprioglio - Federica Gallo - Livia 

Source: https://link.springer.com/



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