The Vaccine and Cervical Cancer Screen project 2 (VACCS 2) : linking cervical cancer screening to a two-dose HPV vaccination schedule in the south-west district of Tshwane, Gauteng, South Africa

摘要

BACKGROUND : Cervical cancer is a preventable disease with a high prevalence in South Africa (SA), where screening is opportunistic.Primary prevention is now possible through HPV vaccination. In VACCS 1 the feasibility of linking cervical cancer with HPV vaccinationwas demonstrated.OBJECTIVES : To investigate the feasibility of linking HPV self-testing with a two-dose HPV vaccination schedule and to compare results withVACCS 1.METHODS : The project was conducted in five schools in the South-West District of Tshwane, Gauteng, SA. Leaflet information on cervicalcancer and screening was provided, with requests for consent and assent for a two-dose HPV vaccination of schoolgirls. Female caregiverswere invited to take part in HPV self-screening.RESULTS : Of 965 girls invited for vaccination, 519 (53.7%) had full consent and 518 (99.8%) received at least one vaccine dose. The inviteduptake rate was 53.7% and 495 girls received both doses, giving a completion rate of 95.4% v. 82.6% in VACCS 1. Of 1 135 self-screen kitshanded out, 560 (49.3%) were not returned. The mean age (standard deviation) of the 160 women who participated in self-screening was38.7 (7.7) years. HPV testing was negative in 116 women (72.5%), 15 women (9.4%) tested positive for HPV 16 and/or 18, and 27 (16.9%)were positive for non-16/18 oncogenic HPV.CONCLUSION : Data from the VACCS projects suggest that school-based vaccine programmes can be successfully implemented. A two-doseschedule allowed for higher completion rates. Linking self-collected HPV screening to HPV vaccination is feasible, is a promising and viablescreening strategy, and reached the appropriate age group for screening.