2022-RA-1625-ESGO Diagnostic performance of PAP-smear and HPV-testing in the follow-up of patients with cervical cancer

Introduction/BackgroundFollow-up of patients after primary treatment for cervical cancer is unanimously recommended although there are no strong data regarding how should we do it.The majority of relapses are detected by performing a proper clinical interview and examination.This calls into question the use of complementary tests such as PAP and HPV testingMethodologyRetrospective descriptive observational study including all patients diagnosed with cervical cancer in the gynaecology-oncology unit of CHUIMI from 2015 to 2018 with subsequent follow-up until 2021.Demographic variables,histological treats,pre-treatment HPV status,type of treatment,post-treatment HPV status,changes in HPV status during follow-up and post-treatment PAP and changes in PAP result during follow-up were recorded.Relapse rate,location and current status of the patient were studiedResults183 patients were included in the study.Sixteen recurrences were detected (8,7%), 12 of which were systemic (75%) and 4 local (25%).We found no association between PAP results during follow-up and subsequent recurrence (p=0.459) or exitus.All patients who relapsed had normal PAP results during follow-up.We found no difference between the percentages of negativation of the different HPV serotypes after treatment(77,1% VPH 16 or 18 vs 76,5% other HRV).In our sample,patients who had persistent VPH positive tests after treatment were not at increased risk of recurrence (p=0.506)or exitus.91,8%(168) of pacients were alive and free of disease at the end of the study,2,7%(5) live with disease and 9 patients died with disease(overall mortality rate of 4,9%) Conclusion guidelines generally recommend PAP and HPV screening because they are minimally invasive and low cost, but according to the available evidence and the data provided by this study,we have information that would support focusing on good anamnesis and examination and educating the patient on the appearance of warning signs