HPV-testing in the cervical cancer program for the age group of 25 to 33 years - Protocol for a systematic review

Summary

Prolonged infections with human papillomavirus (HPV) have a causative role in the development of more than 99% of cervical cancer cases. The majority of HPV infections is nevertheless defeated by the immune system without causing cervical cancer. Since 1995, Norwegian women in the age group of 25 to 69 years have been invited to a national screening program for cervical cancer. The screening program have used conventional cytology to assess cell samples, but from 2022 cell samples will primarily be assessed by HPV-testing for the age group of 34 to 69 years. Also in 2022, the first cohort that was offered the HPV vaccine in the national vaccine program will be invited to the national screening program for cervical cancer.

The purpose of this systematic review is to investigate advantages and disadvantages by using HPV-testing in national screening programs for cervical cancer for the age group of 25 to 33 years. Separate assessments and analysis will be conducted for HPV-vaccinated and unvaccinated cohorts.

We will conduct a systematic literature search in relevant databases. Titles, abstracts, and full texts of relevant references will be assessed against the selection criteria. We will use EPPI-Reviewer in the selection process, including various machine learning functionalities to streamline the selection process. We will extract and analyse data from the included studies and assess their methodological quality with validated checklists and tools. Our confidence in the results, including transferability to the Norwegian context, will also be assessed. The results will be compiled and presented in a report written in Norwegian.