Journal Article Ahead of print
PubMed: 42285416 DOI: 10.1016/j.jogoh.2026.103229
Organized cervical cancer screening in Brittany: follow-up at 1 year after a positive virological test with normal cytology.
J Gynecol Obstet Hum Reprod
Authors: Florianne Martinez, Camille Durand, Zélie Morel, Aurélie Dy Zanoune, Maxime Esvan, Jean Levêque, Ludivine Dion
Affiliations
- Department of Gynecology, Anne de Bretagne University Hospital, 16 Boulevard de Bulgarie, 35200 RENNES.
- Department of Gynecology, Anne de Bretagne University Hospital, 16 Boulevard de Bulgarie, 35200 RENNES; French Society of Colposcopy and Cervical-Vaginal Pathology, 1 rue Charles Péguy 94 000 CRETEIL.
- Regional Cancer Screening Coordination Centre of Brittany, 7 Rue Armand Herpin-Lacroix 35 000 RENNES.
- Clinical Investigation Centre, Pontchaillou University Hospital, 2 rue Henri Le Guilloux 35033 RENNES cedex 9.
- Department of Gynecology, Anne de Bretagne University Hospital, 16 Boulevard de Bulgarie, 35200 RENNES; French Society of Colposcopy and Cervical-Vaginal Pathology, 1 rue Charles Péguy 94 000 CRETEIL; Regional Cancer Screening Coordination Centre of Brittany, 7 Rue Armand Herpin-Lacroix 35 000 RENNES; Department of Surgical Oncology, Eugène Marquis Comprehensive Cancer Center, Rue de la Bataille Flandres Dunkerque CS 44229 35 042 RENNES CEDEX.
Abstract
OBJECTIVE
To assess adherence to the recommended 12-month virological follow-up among women aged 30-65 years living in Brittany (France) who had a positive high-risk HPV test with normal cytology (hrHPV+ / Cytology-) within the French national program of organized cervical cancer screening, and to identify factors associated with follow-up compliance.
METHODS
We conducted a retrospective observational study using data from the Regional Cancer Screening Coordination Center of Brittany collected between July 2020 and March 2023. Women with hrHPV+/Cytology- screening result were included. The primary outcome was completion of a repeat hrHPV test between 6 and 12 months after the initial result, in accordance with French Health Authority (HAS) recommendations. Secondary outcomes included analyze of women characteristics according to age, geographical area, initial sampler taker, and declaration of a general practitioner.
RESULTS
Among 762 113 eligible women, 12 985 (1.7%) had a hrHPV+/Cytology- result. At 1 year, 28.5% had no documented follow-up, and only 21.3% underwent follow-up in accordance with French recommendations, corresponding to 29.8% of women who were followed. Among women with appropriate follow-up, 53% remained hrHPV+, and 81.4% of these were referred for colposcopy. Loss of follow-up was more common among young women, those living in non-urban areas. Conversely, recommended follow-up was more frequent in areas with higher health care availability and among women managed by gynecologists.
CONCLUSION
Implementation of guideline-recommended follow-up after hrHPV+/Cytology- screening remains suboptimal, despite well-documented increased risks of high grade precancerous lesions and invasive cancer in this population. Strategies to improve adherence include personalized reminders, use of self-sampling, personalized invitations to screening, harmonization of professional practices, and optimization of colposcopy referral pathways.
MeSH
Uterine Cervical Neoplasms, Neoplasms, Aged, Cell Biology, Gynecology, Colposcopy, Cytology