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In a review of end-user performance of HPV screening strategies, Wang et al (2009) stated that "[a]n innovative strategy to formalize decision makings across a government and industry partner in countries with high prevalence of cervical cancer will be needed. The agency should have an unpatented method license for HPV screening".
In an article concerning the *better safe than sorry*approach, Renslo et al (2009) stated that "[o]ur findings indicate that the possible benefits of HPV testing on cost per death averted are only modest in the most vulnerable age groups where these benefits may be especially important".
A study conducted by 1 of the authors (Ogg) highlighted a current unresolved issue regarding the potential to use risk estimates for screening to inform decisions about the use of HPV testing (and cytology) for screening. The outcome measure of interest was the evidential value of the observed test performance measures in discriminating between women who, on the one extreme, would avoid all interventions and, on the other extreme, would receive the recommended interventions [i.e., repeat for cytology and subsequently for HPV testing (and colposcopies)]. The evidence indicates that there is some potential for these test measures to inform this kind of triage decision pertaining to the use of HPV testing for cervical cancer screening but at best there is moderate concordance among these test measures. The article prompted the authors to recommend the careful interpretation and consideration of other decision-making factors when considering the use of HPV testing for cervical cancer screening, more specifically, the acceptability of the informed consent process to women, industry uncertainties, and the accuracy of the underlying data for the presumed "true" population prevalence of HPV. In this context, the use of HPV testing for the purpose of triage has the potential to reduce cost and increase program efficiency.
In a study involving 39 countries, Webber et al (2009) observed the current cervical cancer screening practice patterns in Africa. The data they reported in this journal, revealed significant variations in the performance of cervical cancer prevention interventions in across Africa [p < 0.05]. d2c66b5586