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P066 What kinds of changes did the publication of large-scale RCTs related to HPV testing lead to in cervical cancer screening guidelines?
  1. C Hamashima1,
  2. T Kishi2
  1. 1National Cancer Center, Tokyo, Japan
  2. 2Keio University, Tokyo, Japan

Abstract

Objectives Although the mortality of cervical cancer has decreased in developed countries, HPV testing has been anticipated as a new technique for cervical cancer screening. Since 2009, three RCTs have reported final outcomes that evaluated reduction of the mortality of cervical cancer or of the incidence of invasive cancer. Changes in the assessment of HPV testing in guidelines, evidence reports, and statements are examined.

Methods A search was performed from January 2010 to January 2012 using MEDLINE, the GIN library, and the National Guidelines Clearinghouse to identify guidelines, evidence reports, and statements that evaluated HPV testing. Additional reports recommended by experts were also included as needed. Assessments of HPV testing and related evidence were compared.

Results Eight guidelines and two evidence reports matching our criteria were identified. When HPV testing was recommended and introduced, it was based on the results of studies conducted in the respective countries. The methods of HPV testing were different, because interpretations of the results of the RCTs were different among these guidelines and reports.

Discussion Although new techniques are expected to be introduced early in comminutes, long follow-up is needed to evaluate efficacy. In such situations, studies conducted in respective countries are often considered to represent favourable results. To resolve this problem, a modelling approach could be used, but the appropriateness of such an approach for guideline development needs to be investigated.

Implication for Guideline Developers To evaluate the efficacy of a new technique, modelling studies should be standardised for guideline development.

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