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dc.contributor.author
Arrossi, Silvina  
dc.contributor.author
Thouyaret, Laura  
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Herrero, Rolando  
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Campanera, Alicia  
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Magdaleno, Adriana  
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Cuberli Alonso, Milca Beatriz  
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Barletta, Paula  
dc.contributor.author
Laudi, Rosa  
dc.contributor.author
Orellana, Liliana  
dc.date.available
2018-07-11T14:23:49Z  
dc.date.issued
2015-02  
dc.identifier.citation
Arrossi, Silvina; Thouyaret, Laura; Herrero, Rolando; Campanera, Alicia; Magdaleno, Adriana; et al.; Effect of self-collection of HPV DNA offered by community health workers at home visits on uptake of screening for cervical cancer (the EMA study): A population-based cluster-randomised trial; Elsevier; The Lancet Global Health; 3; 2; 2-2015; e85-e94  
dc.identifier.issn
2214-109X  
dc.identifier.uri
http://hdl.handle.net/11336/51710  
dc.description.abstract
Background: Control of cervical cancer in developing countries has been hampered by a failure to achieve high screening uptake. HPV DNA self-collection could increase screening coverage, but implementation of this technology is difficult in countries of middle and low income. We investigated whether offering HPV DNA self-collection during routine home visits by community health workers could increase cervical screening. Methods: We did a population-based cluster-randomised trial in the province of Jujuy, Argentina, between July 1, 2012, and Dec 31, 2012. Community health workers were eligible for the study if they scored highly on a performance score, and women aged 30 years or older were eligible for enrolment by the community health worker. 200 community health workers were randomly allocated in a 1:1 ratio to either the intervention group (offered women the chance to self-collect a sample for cervical screening during a home visit) or the control group (advised women to attend a health clinic for cervical screening). The primary outcome was screening uptake, measured as the proportion of women having any HPV screening test within 6 months of the community health worker visit. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02095561. Findings: 100 community health workers were randomly allocated to the intervention group and 100 were assigned to the control group; nine did not take part. 191 participating community health workers (94 in the intervention group and 97 in the control group) initially contacted 7650 women; of 3632 women contacted by community health workers in the intervention group, 3049 agreed to participate; of 4018 women contacted by community health workers in the control group, 2964 agreed to participate. 2618 (86%) of 3049 women in the intervention group had any HPV test within 6 months of the community health worker visit, compared with 599 (20%) of 2964 in the control group (risk ratio 4·02, 95% CI 3·44-4·71). Interpretation: Offering self-collection of samples for HPV testing by community health workers during home visits resulted in a four-fold increase in screening uptake, showing that this strategy is effective to improve cervical screening coverage. This intervention reduces women's barriers to screening and results in a substantial and rapid increase in coverage. Our findings suggest that HPV testing could be extended throughout Argentina and in other countries to increase cervical screening coverage. Funding: Instituto Nacional del Cáncer (Argentina).  
dc.format
application/pdf  
dc.language.iso
eng  
dc.publisher
Elsevier  
dc.rights
info:eu-repo/semantics/openAccess  
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/  
dc.subject
Argentina  
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Hpv- Test Self-Collection  
dc.subject
Effectiveness  
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Screening  
dc.subject.classification
Salud Ocupacional  
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Ciencias de la Salud  
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CIENCIAS MÉDICAS Y DE LA SALUD  
dc.title
Effect of self-collection of HPV DNA offered by community health workers at home visits on uptake of screening for cervical cancer (the EMA study): A population-based cluster-randomised trial  
dc.type
info:eu-repo/semantics/article  
dc.type
info:ar-repo/semantics/artículo  
dc.type
info:eu-repo/semantics/publishedVersion  
dc.date.updated
2018-07-05T13:12:55Z  
dc.journal.volume
3  
dc.journal.number
2  
dc.journal.pagination
e85-e94  
dc.journal.pais
Estados Unidos  
dc.journal.ciudad
Nueva York  
dc.description.fil
Fil: Arrossi, Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudio de Estado y Sociedad; Argentina  
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Fil: Thouyaret, Laura. Instituto Nacional del Cáncer; Argentina  
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Fil: Herrero, Rolando. International Agency for Research on Cancer; Francia  
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Fil: Campanera, Alicia. Ministerio de Salud de la Provincia de Jujuy; Argentina  
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Fil: Magdaleno, Adriana. Ministerio de Salud de la Provincia de Jujuy; Argentina  
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Fil: Cuberli Alonso, Milca Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional del Cáncer; Argentina  
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Fil: Barletta, Paula. Instituto Nacional del Cáncer; Argentina  
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Fil: Laudi, Rosa. Programa Nacional de Prevención de Cáncer Cervicouterino; Argentina  
dc.description.fil
Fil: Orellana, Liliana. Instituto Nacional del Cáncer; Argentina  
dc.journal.title
The Lancet Global Health  
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/https://dx.doi.org/10.1016/S2214-109X(14)70354-7  
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S2214109X14703547