HPV screening and follow-up pathway

Evaluation, monitoring and reporting

Recommendation: Develop an evaluation plan to assess any expected or unexpected changes in the shift from cytology testing to HPV primary screening.

Key evidence and implementation considerations:

• An evaluation plan may include:¹
  • participation rates
  • retention rates for subsequent rounds of screening
  • recall rates or abnormal test rates
  • compliance with follow-up Pap tests and/or colposcopy for abnormal screening results
  • screening practices that align with screening guidelines for starting age, screening intervals and stopping age
  • screening outcomes by age group, HPV immunization status, geography and other relevant factors.
• The performance of HPV testing needs to be monitored within jurisdictions to ensure key performance indicators align with expected results. ¹
• Jurisdictions should prepare to collect and access monitoring data, access information system support, and build analytic capacity to utilize the data. ¹
• Both quantitative and qualitative data as well as process and outcome indicators, including lessons learned, barriers and facilitators of the implementation process, should be evaluated.¹
• Reporting of select programmatic indicators at a pan-Canadian level will demonstrate the health and economic outcomes of HPV primary screening implementation and enable knowledge sharing among jurisdictions.

Recommendation: Jurisdictions should implement a strategy to collect data on participant immunization status to evaluate the impact of HPV immunization on HPV case counts and cervical cancer development.

Recommendation: Jurisdictions should continue to collect screening results and follow-up outcome information in screening registries.

Key evidence and implementation considerations:

• As jurisdictions shift to HPV tests as the primary screening test, results may be reported by different laboratories or organizations. Ensuring results continue to be reported to screening programs will enable them to monitor screening and outcomes as the test changes.
• Jurisdictions could include a personalized QR code on self-samples that are mailed out. This will ensure that these participants are included in a registry because they can be easily identified with a QR code.