Cervical screening using HPV-DNA cytology in a low-income setting: an audit within a socio-economically deprived rural community in the Philippines
Cervical screening using HPV-DNA cytology in a low-income setting: an audit within a socio-economically deprived rural community in the Philippines.
Journal of Global Health Reports, 7, e2023047.
Cervical cancer (CC) is the second leading cause of cancer among women in the Philippines, mainly caused by a persistent human papillomavirus infection (HPV). We aimed to determine the prevalence of HPV and compare screening methods within a socio-economically deprived rural community in the Philippines.
We conducted a retrospective audit of the medical records of 872 women from the free Women’s clinic in a regional Philippines community over the period, 2013-2019. All participants were screened for CC using the VIA/VILI method, with only 284 women tested for HPV using the HPV-polymerase chain reaction (HPV-PCR) method. For the 284, we compared their HPV-PCR and VIA/VILI results. Data was de-identified and descriptively analysed.
Thirteen different HPV subtypes, all oncogenic, exist in the community. HPV was detected in 32 (11%) of the 284 women tested. Of note, 28 patients who had an oncogenic HPV infection had a normal VIA/VILI inspection result. The bivalent vaccine protects only 6% of the HPV-positive cases in the clinic.
This study suggests HPV-PCR testing is superior at detecting HPV before cervical changes occur. The different oncogenic HPV strains reflect the low coverage of the bivalent HPV vaccination in the community – a key area for practice and policy reforms. Further studies on the prevalence of oncogenic HPV strains will be vital in designing suitable preventive care programs for CC.
HPV, Cervical cancer, Cancer screening, Low income community, Vaccination