Barcena Barbeira Pilar, Paolino Melisa, Binder Fernando, Almonte Maribel, Baena Armando, Mazzadi Juan David, Arrossi Silvina
Centro de Estudios de Estado y Sociedad Buenos Aires Argentina Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina.
Universidad de Buenos Aires Buenos Aires Argentina Universidad de Buenos Aires, Buenos Aires, Argentina.
Rev Panam Salud Publica. 2025 Aug 28;49:e92. doi: 10.26633/RPSP.2025.92. eCollection 2025.
To evaluate implementation of the second round of human papillomavirus (HPV)-based cervical screening, introduced in Argentina in 2012-2014 through the Jujuy Demonstration Project for women 30 years and older, and describe the characteristics of women who adhere to the recommended five-year rescreening interval.
A retrospective cohort study was conducted based on the data of two rounds of screening. All women aged 30 years or older who had been HPV-tested during the Jujuy Demonstration Project and had a negative result were included. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to evaluate implementation. Multivariable regression was used to examine factors associated with adherence to rescreening.
Of 42 307 HPV-negative women, 47.9% ( = 20 285) were rescreened in the second round (Reach); 69.2% of health centers provided at least one HPV test at second-round screening (Adoption); and 13.3% ( = 5 639) of women were rescreened within the recommended five-year interval. Among the total rescreened, 9.3% ( = 1 888) were HPV-positive, of which 95.0% underwent triage Pap and 79.2% of the HPV-positive/abnormal Pap women had colposcopy. Considering women rescreened at five years, the second-round detection rate was 5.3/1 000 screened women. Rescreening at five years was significantly higher among women aged 30-44, with public health insurance, and those living in the provincial capital.
Rescreening of HPV-negative women faced challenges linked to its reduced reach, especially if we consider the recommended five-year interval. Our findings suggest that we need to devise specific strategies to increase second-round screening rates.
评估2012 - 2014年通过胡胡伊示范项目在阿根廷为30岁及以上女性引入的第二轮基于人乳头瘤病毒（HPV）的宫颈癌筛查的实施情况，并描述坚持推荐的五年复查间隔的女性特征。
基于两轮筛查数据进行回顾性队列研究。纳入所有在胡胡伊示范项目期间接受HPV检测且结果为阴性的30岁及以上女性。采用“覆盖、效果、采用、实施和维持”（RE - AIM）框架评估实施情况。使用多变量回归分析与复查依从性相关的因素。
在42307名HPV阴性女性中，47.9%（n = 20285）在第二轮进行了复查（覆盖）；69.2%的健康中心在第二轮筛查中至少提供了一次HPV检测（采用）；13.3%（n = 5639）的女性在推荐的五年间隔内进行了复查。在所有复查者中，9.3%（n = 1888）为HPV阳性，其中95.0%接受了分流巴氏涂片检查，79.2%的HPV阳性/巴氏涂片异常女性进行了阴道镜检查。考虑到在五年时进行复查的女性，第二轮检测率为每1000名筛查女性中有5.3例。30 - 44岁、有公共医疗保险且居住在省会的女性在五年时的复查率显著更高。
HPV阴性女性的复查面临与覆盖范围降低相关的挑战，特别是如果考虑推荐的五年间隔。我们的研究结果表明，我们需要制定具体策略以提高第二轮筛查率。
