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The human papillomavirus Test of Cure: a lesson on compliance with the NHMRC guidelines on screening to prevent cervical cancer
Australian and New Zealand Journal of Obstetrics and Gynaecology (2015)
  • Aime Munro, WA Cervical Cancer Prevention Program
  • Katrina Spilsbury, Curtin University
  • Lee Leung, The University of Western Australia
  • Peter O'Leary, Curtin University
  • Vincent Williams, Curtin University
  • Professor Jim Codde, The University of Notre Dame Australia
  • Nerida Steel, WA Cervical Cancer Prevention Program
  • Paul Cohen, The University of Western Australia
  • James Semmens, Curtin University
Abstract
Background: In Australia, high-risk human papillomavirus (HR HPV) testing is recommended for follow-up of women
treated for a high-grade squamous intra-epithelial lesion (HSIL). The sensitivity of HR HPV testing is critical to identify
women at risk of further high-grade cervical disease. In Australia, this management protocol is known as the ‘Test of
Cure’ (ToC).
Aim: To conduct a population-based study investigating practitioners’ compliance with ToC.
Materials and Methods: Women treated for an HSIL between the five-year period 01 Jan 2006 to 31 Dec 2010 were
identified and followed up for at least a 27-month period. Proportions and relative odds were determined for women
entering and completing the ToC management pathway within recommended time frames.
Results: There were 5,194 women identified as ‘eligible’ to enter the ToC management pathway. Of these, 1,916 (37%)
were managed with annual Pap smears and never had a HR HPV test performed. There were 1,296 (25%) women who
entered the ToC management pathway within recommended time frames, and a further 1,978 (38%) women entered
outside of the recommended time frames. Overall, 961 women completed the ToC and were classified as ‘cured’ and were
eligible to return to two-yearly Pap smears. Women’s demographic information was significantly associated with ToC
commencement, specifically, age and year of treatment, and Index of Relative Socioeconomic Disadvantage.
Conclusion: Overall, a significant number of Australian women did not enter (~37%) and complete (~50%) the ToC
management pathway. The challenge remains to advocate its use to practitioners to ensure women are returned to the
population screening interval in a timely manner.
Publication Date
2015
DOI
10.1111/ajo.12309
Citation Information
Munro, A., Spilsbury, K., Leung, L., et al. ( 2015). The human papillomavirus Test of Cure: a lesson on compliance with the NHMRC guidelines on screening to prevent cervical cancer. Australian and New Zealand Journal of Obstetrics and Gynaecology, 55(2), 185-190. DOI: 10.1111/ajo.12309