Introduction
Different approaches to screening and treatment of cervical precancer
Anatomical considerations
Physiological changes of the cervical epithelium
Neoplastic changes of the cervical epithelium
HPV tests – Variation between tests
Instruments, consumables, and setup required
Procedure to collect samples for HPV testing
Interpretation of HPV test results
Management of women with a positive HPV test result
Treatment of cervical intraepithelial neoplasia – principles
Steps to determine eligibility for ablative treatment
Role of Lugol’s iodine in identifying the transformation zone for treatment
Treatment by cryotherapy
Treatment by thermal ablation
Using an HPV test as the test of cure in women treated for cervical abnormalities or cervical intraepithelial neoplasia (CIN)
Infection prevention
Case studies
VIA triage outcome (applicable in screen-and-treat setting only) – negative cases
VIA triage outcome – positive cases
VIA triage outcome – suspicious of cancer cases
Foreword
Acknowledgement
Authors
Suggested citation
Copyright
Home / Training / Manuals / Using HPV tests for cervical cancer screening and managing HPV-positive women – a practical online guide / Foreword
It is amazing to think that cervical cancer, the fourth most common cancer type in women today, could be eliminated as a public health problem within the next decades. Cervical cancer kills more than 300 000 women per year globally, and about 90% of these deaths occur in low- and middle-income countries. Elimination of cervical cancer is possible through vaccination of adolescent girls against human papillomavirus (HPV), screening of women with HPV testing, and appropriate management of screen-detected cervical precursor lesions and cancers. In November 2020, the World Health Organization (WHO) formally adopted a global strategy to accelerate the elimination of cervical cancer as a public health problem worldwide. The strategy incorporates three specific targets to be achieved by 2030 by every country: vaccinating at least 90% of adolescent girls against HPV, screening at least 70% of women aged 30–49 years with an HPV test at least twice in their lifetime, and appropriate management of 90% of women with cervical precancer or cancer.
There is compelling evidence that primary screening with an HPV test is superior to cervical cytology or visual inspection of the cervix with acetic acid (VIA). Although the HPV tests that are currently available are expensive and are not yet widely available in all countries and regions, there is a concerted effort by all stakeholders to introduce point-of-care, affordable, and low-technology HPV tests to ensure that even low-income countries can offer HPV screening in the near future. HPV testing on self-collected vaginal samples is a significant advance that will simplify the logistic challenges of implementing HPV-based screening in all settings and empower women for self-care. There is an urgent and important need to train large numbers of health-care providers to administer HPV tests, interpret the results, and manage the screen-positive women appropriately.
Using HPV tests for cervical cancer screening and managing HPV-positive women – a practical online guide, an atlas from the International Agency for Research on Cancer (IARC), is a step-by-step online resource for self-learning. It covers the natural history of cervical cancer, the principles of HPV testing and different HPV tests for screening, steps for the collection of specimens for HPV testing, interpretation of the test results, and management of screen-positive women, including women living with HIV. This atlas is aligned with the latest WHO guidelines on screening and management of screen-positive women. I hope that this atlas will be an extremely useful resource for providers of cervical cancer screening and appropriate management in all countries that are implementing HPV-based cervical cancer screening.
This atlas, which is freely available online, is a valuable resource for capacity-building of providers and provides a meaningful contribution to the WHO initiative to eliminate cervical cancer as a public health problem globally.
Click to return to the atlas
Using HPV tests for cervical cancer screening and managing HPV-positive women – a practical online guide
Filter by language: English / Français / EspañolForeword
It is amazing to think that cervical cancer, the fourth most common cancer type in women today, could be eliminated as a public health problem within the next decades. Cervical cancer kills more than 300 000 women per year globally, and about 90% of these deaths occur in low- and middle-income countries. Elimination of cervical cancer is possible through vaccination of adolescent girls against human papillomavirus (HPV), screening of women with HPV testing, and appropriate management of screen-detected cervical precursor lesions and cancers. In November 2020, the World Health Organization (WHO) formally adopted a global strategy to accelerate the elimination of cervical cancer as a public health problem worldwide. The strategy incorporates three specific targets to be achieved by 2030 by every country: vaccinating at least 90% of adolescent girls against HPV, screening at least 70% of women aged 30–49 years with an HPV test at least twice in their lifetime, and appropriate management of 90% of women with cervical precancer or cancer.
There is compelling evidence that primary screening with an HPV test is superior to cervical cytology or visual inspection of the cervix with acetic acid (VIA). Although the HPV tests that are currently available are expensive and are not yet widely available in all countries and regions, there is a concerted effort by all stakeholders to introduce point-of-care, affordable, and low-technology HPV tests to ensure that even low-income countries can offer HPV screening in the near future. HPV testing on self-collected vaginal samples is a significant advance that will simplify the logistic challenges of implementing HPV-based screening in all settings and empower women for self-care. There is an urgent and important need to train large numbers of health-care providers to administer HPV tests, interpret the results, and manage the screen-positive women appropriately.
Using HPV tests for cervical cancer screening and managing HPV-positive women – a practical online guide, an atlas from the International Agency for Research on Cancer (IARC), is a step-by-step online resource for self-learning. It covers the natural history of cervical cancer, the principles of HPV testing and different HPV tests for screening, steps for the collection of specimens for HPV testing, interpretation of the test results, and management of screen-positive women, including women living with HIV. This atlas is aligned with the latest WHO guidelines on screening and management of screen-positive women. I hope that this atlas will be an extremely useful resource for providers of cervical cancer screening and appropriate management in all countries that are implementing HPV-based cervical cancer screening.
This atlas, which is freely available online, is a valuable resource for capacity-building of providers and provides a meaningful contribution to the WHO initiative to eliminate cervical cancer as a public health problem globally.
 | Dr Elisabete Weiderpass Director, International Agency for Research on Cancer |
Click to return to the atlas