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Brest University Hospital, France
Posters & Accepted Abstracts: Virol-mycol
The PapU29 study was designed as an alternative strategy for cervical cancer screening. In Europe, cytology-based screening coverage varies from 40-80%; it is around 55% in France and down to 25% in some areas. The aim of screening programs is to reach 80% coverage. Since Human Papillomavirus (HPV) is found in almost all cervical cancer and pre cancer lesions, screening strategies based on HPV testing are proposed. To facilitate access to these tests, vaginal self-sampling has been largely studied. Therefore, we developed an urine HPV test, with more than 80% concordance with cytology and vaginal self-sample testing. Our urine HPV test has been proposed at home in Finist�?¨re to 12,498 non-attendees women, with no cytology over 3 years (2008-2010); among them 3078 (28%) sent by mail their urine sample to our lab for testing; 764 (28%) were found HPVpositive and 51 among them had abnormal cytology (8%) with 12 pre cancer CIN2+ lesions and 1 cervical cancer (1/5000 expected). A five year follow-up showed no pre cancer lesions in urine HPV-negative women (n=687). All cancer and pre cancer women were treated and no relapse was observed. Evaluation of this strategy in Finist�?¨re (n=124,279) and Gironde (n=217,255), west and southwest areas in France, avoided cancer accounted to 5.5 and 31.5 in the cytology group and the urine HPV group respectively, costs per screened CIN2+ woman would be 44,879â�?¬ and 16,910â�?¬ respectively in these groups. This cost could be reduced to 7424â�?¬ if the urine HPV strategy is restricted to 35-49 old women.