Development of models for cervical cancer screening: construction in a cross-sectional population and validation in two screening cohorts in China.
Zeni Wu,Tingyuan Li,Tingyuan Li,Yongli Han,Mingyue Jiang,Yanqin Yu,Hui-Fang Xu,Lulu Yu,Jianfeng Cui,Bin Liu,Feng Chen,Jian Yin,Xun Zhang,Qin-Jing Pan,You-Lin Qiao,Wen Chen +15 more
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In this paper, the authors developed and evaluated a more accurate model for cervical cancer screening using age, cytology, high-risk human papillomavirus (hrHPV) DNA/mRNA, E6 oncoprotein, HPV genotyping, and p16/Ki-67.Abstract:
Current methods for cervical cancer screening result in an increased number of referrals and unnecessary diagnostic procedures. This study aimed to develop and evaluate a more accurate model for cervical cancer screening. Multiple predictors including age, cytology, high-risk human papillomavirus (hrHPV) DNA/mRNA, E6 oncoprotein, HPV genotyping, and p16/Ki-67 were used for model construction in a cross-sectional population including women with normal cervix (N = 1085), cervical intraepithelial neoplasia (CIN, N = 279), and cervical cancer (N = 551) to predict CIN2+ or CIN3+. A base model using age, cytology, and hrHPV was calculated, and extended versions with additional biomarkers were considered. External validations in two screening cohorts with 3-year follow-up were further conducted (NCohort-I = 3179, NCohort-II = 3082). The base model increased the area under the curve (AUC, 0.91, 95% confidence interval [CI] = 0.88–0.93) and reduced colposcopy referral rates (42.76%, 95% CI = 38.67–46.92) compared to hrHPV and cytology co-testing in the cross-sectional population (AUC 0.80, 95% CI = 0.79–0.82, referrals rates 61.62, 95% CI = 59.4–63.8) to predict CIN2+. The AUC further improved when HPV genotyping and/or E6 oncoprotein were included in the base model. External validation in two screening cohorts further demonstrated that our models had better clinical performances than routine screening methods, yielded AUCs of 0.92 (95% CI = 0.91–0.93) and 0.94 (95% CI = 0.91–0.97) to predict CIN2+ and referrals rates of 17.55% (95% CI = 16.24–18.92) and 7.40% (95% CI = 6.50–8.38) in screening cohort I and II, respectively. Similar results were observed for CIN3+ prediction. Compared to routine screening methods, our model using current cervical screening indicators can improve the clinical performance and reduce referral rates.read more
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Developing a predictive nomogram for colposcopists: a retrospective, multicenter study of cervical precancer identification in China
TL;DR: In this article , the authors developed and validated a nomogram which incorporates multiple clinically relevant variables to better identify HSIL+ cases during colposcopic examination. But the model was externally validated with 472 consecutive patients and compared to 422 other patients from two additional hospitals.
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Mathematical Modelling of Cervical Precancerous Lesion Grade Risk Scores: Linear Regression Analysis of Cellular Protein Biomarkers and Human Papillomavirus E6/E7 RNA Staining Patterns
Sureewan Bumrungthai,Tipaya Ekalaksananan,Pilaiwan Kleebkaow,Khajohnsilp Pongsawatkul,Pisit Phatnithikul,Jirad Jaikan,Puntanee Raumsuk,Sureewan Duangjit,Datchani Chuenchai,Chamsai Pientong +9 more
TL;DR: In this paper , the authors used mathematical models to predict the risk of cervical lesion progression and identifying precancerous lesions in patients in northern Thailand by evaluating the expression of multiple biomarkers.
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Evaluating the Feasibility of Machine-Learning-Based Predictive Models for Precancerous Cervical Lesions in Patients Referred for Colposcopy
TL;DR: Wang et al. as mentioned in this paper evaluated the feasibility of machine learning (ML) models for predicting high-grade squamous intraepithelial lesions or worse (HSIL+) in patients referred for colposcopy by combining colposcopic findings with demographic and screening results.
References
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Colposcopically directed biopsy, random cervical biopsy, and endocervical curettage in the diagnosis of cervical intraepithelial neoplasia II or worse.
Robert G. Pretorius,Wen-hua Zhang,Jerome L. Belinson,Man Ni Huang,Ling Ying Wu,Xun Zhang,You-Lin Qiao +6 more
TL;DR: In this paper, the authors determined the relative importance of colposcopically directed biopsy, random biopsy and endocervical curettage (ECC) in diagnosing ≥cervical intraepithelial neoplasia (CIN) II.
Journal ArticleDOI
Cytology versus HPV testing for cervical cancer screening in the general population
George Koliopoulos,Victoria Nyawira Nyaga,Nancy Santesso,Andrew Bryant,Pierre Martin-Hirsch,Reem A. Mustafa,Holger J. Schünemann,Evangelos Paraskevaidis,Marc Arbyn +8 more
TL;DR: The quality of the evidence for the sensitivity of the tests was moderate, and high for the specificity, and the results did not differ by age of women (less than or greater than 30 years old), or in studies with verification bias.
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p16/Ki-67 Dual Stain Cytology for Detection of Cervical Precancer in HPV-Positive Women
Nicolas Wentzensen,Barbara Fetterman,Philip E. Castle,Mark Schiffman,Shannon N. Wood,Eric Stiemerling,Diane Tokugawa,Clara Bodelon,Nancy Poitras,Thomas Lorey,Walter Kinney +10 more
TL;DR: Dual stain cytology showed good risk stratification for all HPV- positive women and for HPV-positive women with normal cytology and additional follow-up is needed to determine how long dual stain negative women remain at low risk of precancer.
Journal ArticleDOI
An Evaluation of Novel, Lower-Cost Molecular Screening Tests for Human Papillomavirus in Rural China
Fang-Hui Zhao,Jose Jeronimo,You-Lin Qiao,Johannes Schweizer,Wen Chen,Melissa Valdez,Peter S. Lu,Xun Zhang,Le Ni Kang,Pooja Bansil,Proma Paul,Charles W. Mahoney,Marthe Berard-Bergery,Ping Bai,Roger Peck,Jing Li,Feng Chen,Mark H. Stoler,Philip E. Castle +18 more
TL;DR: HPV E6 oncoprotein detection is useful for identifying women who have cervical precancer and cancer and had the greatest positive predictive value (PPV), compared with the other tests, which had a PPV of less than 10%.
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A cohort study of cervical screening using partial HPV typing and cytology triage.
Mark Schiffman,Noorie Hyun,Tina Raine-Bennett,Hormuzd A. Katki,Barbara Fetterman,Julia C. Gage,Li C. Cheung,Brian Befano,Nancy Poitras,Thomas Lorey,Philip E. Castle,Nicolas Wentzensen +11 more
TL;DR: The prospectively evaluated combinations of partial HPV typing and cytology triage and explored whether management could be simplified, based on grouping combinations yielding similar 3‐year or 18‐month CIN3+ risks, to support primary HPV testing.