HPV - based cervical cancer screening

Clinical
1

For the past year and a half, I’ve been working at the cervical cancer screening program at the Oncology Institute Ljubljana where OpenEHR is used as the underlying clinical modelling approach to our screening program renewal that is to be supported by a our new information system.

As part of the renewal of our screening policy, we plan a transition to HPV-based screening – currently we are still based on PAP smears.

To support the new HPV-based screening, we would like to improve our current HPV-related archetypes and templates – especially the HPV report – to be able to capture all the date coming from the liquid cytology analysis machines etc.

For this purpose, I was thinking, that contacting people in the OpenEHR community who have already done some work related to cervix, would be a good idea.

So, I wonder, are there any community members here, that have already done some work on HPV, or have an interest in doing so?

Thank you!

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2

Karolinksa is doing some oncology @erik.sundvall and catalonia @xabiermichelena .

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3

Hi Mate,

It is a very long time since I did some work on cervical screening but my impression is that HPV does not change the dial too much.

Basically we need to record

  1. The Result, including Sample insufficient etc
  2. The Recommendation - review , refer etc
  3. Handling initial screening dates, review dates, follow-up. invitation management.

As I understand it, the only thing that really changes is the Result itself, which in the clinical examples I have seen is pretty simple and can be handled by a typical Lab test/ lab analyte combination. Perhaps there is more detailed in-lab detail that is not normally sent to the patient record system. Do you have an example of the output of the lab for HPV screening?

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4

I’ll check if I can get some liquid cytology output examples as we have not yet actually purchased the machines yet.

5

Great! Thanks for pointing this out!

6

This might be useful: Cervical screening: laboratories providing HPV testing and cytology services in the NHS Cervical Screening Programme - GOV.UK

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7

And then the main issues I have is off course about the governance. Is it now clearer how to bring an archetype to the published state?

8

The process is still the same - create a local archetype then upload it to CKM as a proposal. The only issue is that it can take long time to go through that process. However, I think there is a very strong possibility that you will not need any new archetypes. I suspect the standard lab test/analyte pattern will be good enough, with some templating. Once we know the scope of the analyser output, we should know more.

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