Journal ArticleDOI
Human Papillomavirus and Papanicolaou Tests to Screen for Cervical Cancer
Pontus Naucler,Walter Ryd,Sven Törnberg,Anders Strand,Göran Wadell,Kristina Elfgren,Thomas Rådberg,Björn Strander,Bo Johansson,Ola Forslund,Bengt-Göran Hansson,Eva Rylander,Joakim Dillner +12 more
TLDR
The addition of an HPV test to the Pap test to screen women in their mid-30s for cervical cancer reduces the incidence of grade 2 or 3 cervical intraepithelial neoplasia or cancer detected by subsequent screening examinations.Abstract:
Background Screening for cervical cancer based on testing for human papillomavirus (HPV) increases the sensitivity of detection of high-grade (grade 2 or 3) cervical intraepithelial neoplasia, but whether this gain represents overdiagnosis or protection against future high-grade cervical epithelial neoplasia or cervical cancer is unknown. Methods In a population-based screening program in Sweden, 12,527 women 32 to 38 years of age were randomly assigned at a 1:1 ratio to have an HPV test plus a Papanicolaou (Pap) test (intervention group) or a Pap test alone (control group). Women with a positive HPV test and a normal Pap test result were offered a second HPV test at least 1 year later, and those who were found to be persistently infected with the same high-risk type of HPV were then offered colposcopy with cervical biopsy. A similar number of double-blinded Pap smears and colposcopies with biopsy were performed in randomly selected women in the control group. Comprehensive registry data were used to follow the women for a mean of 4.1 years. The relative rates of grade 2 or 3 cervical intraepithelial neoplasia or cancer detected at enrollment and at subsequent screening examinations were calculated. Results At enrollment, the proportion of women in the intervention group who were found to have lesions of grade 2 or 3 cervical intraepithelial neoplasia or cancer was 51% greater (95% confidence interval [CI], 13 to 102) than the proportion of women in the control group who were found to have such lesions. At subsequent screening examinations, the proportion of women in the intervention group who were found to have grade 2 or 3 lesions or cancer was 42% less (95% CI, 4 to 64) and the proportion with grade 3 lesions or cancer was 47% less (95% CI, 2 to 71) than the proportions of control women who were found to have such lesions. Women with persistent HPV infection remained at high risk for grade 2 or 3 lesions or cancer after referral for colposcopy. Conclusions The addition of an HPV test to the Pap test to screen women in their mid-30s for cervical cancer reduces the incidence of grade 2 or 3 cervical intraepithelial neoplasia or cancer detected by subsequent screening examinations.read more
Citations
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Sexually transmitted diseases treatment guidelines, 2010.
TL;DR: These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 18-30, 2009.
Journal ArticleDOI
American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer
Debbie Saslow,Diane Solomon,Herschel W. Lawson,Maureen Killackey,Shalini L Kulasingam,Joanna M. Cain,Francisco A.R. Garcia,Ann T. Moriarty,Alan G. Waxman,David C. Wilbur,Nicolas Wentzensen,Levi S. Downs,Mark Spitzer,Anna-Barbara Moscicki,Eduardo L. Franco,Mark H. Stoler,Mark Schiffman,Philip E. Castle,Evan R. Myers +18 more
TL;DR: An update to the ACS guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented, addressing age‐appropriate screening strategies, including the use of cytology and high‐risk human papillomavirus (HPV) testing.
Journal ArticleDOI
Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials
Guglielmo Ronco,Joakim Dillner,K. Miriam Elfström,Sara Tunesi,Peter J.F. Snijders,Marc Arbyn,Henry C Kitchener,Nereo Segnan,Clare Gilham,Paolo Giorgi-Rossi,Johannes Berkhof,Julian Peto,Chris J.L.M. Meijer +12 more
TL;DR: Data of large-scale randomised trials support initiation of HPV-based screening from age 30 years and extension of screening intervals to at least 5 years, and provide 60-70% greater protection against invasive cervical carcinomas compared with cytology.
Acog practice bulletin
TL;DR: Much of the review will, of necessity, focus on general principles of critical care, extrapolating where possible to obstetric critical care.
Journal ArticleDOI
Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation Statement
TL;DR: New evidence on the comparative test performance of liquid-based cytology and the benefits and harms of human papillomavirus testing as a stand-alone test or in combination with cytology is reviewed.
References
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Journal ArticleDOI
The causal relation between human papillomavirus and cervical cancer
TL;DR: It is the right time for medical societies and public health regulators to consider the causal role of human papillomavirus infections in cervical cancer and to define its preventive and clinical implications.
Journal ArticleDOI
Overview of the European and North American studies on HPV testing in primary cervical cancer screening.
Jack Cuzick,Christine Clavel,Karl Ulrich Petry,Chris J.L.M. Meijer,Heike Hoyer,Sam Ratnam,Anne Szarewski,Philippe Birembaut,Shalini L Kulasingam,Peter Sasieni,Thomas Iftner +10 more
TL;DR: The results support the use of HPV testing as the sole primary screening test, with cytology reserved for women who test HPV positive, with large demonstration projects needed to fully evaluate this strategy.
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Diagnostic cytology and its histopathologic bases
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Journal ArticleDOI
A general primer GP5+/GP6(+)-mediated PCR-enzyme immunoassay method for rapid detection of 14 high-risk and 6 low-risk human papillomavirus genotypes in cervical scrapings.
M. V. Jacobs,Peter J.F. Snijders,A. J. C. Van Den Brule,Th.J.M. Helmerhorst,Chris J.L.M. Meijer,Jan M. M. Walboomers +5 more
TL;DR: This novel HR/LR HPV PCR-EIA allows accurate and rapid identification of high-risk and low-risk HPV types in cervical scrapings and will facilitate HPV detection in HPV mass-screening programs.
Journal ArticleDOI
Type-specific persistence of human papillomavirus DNA before the development of invasive cervical cancer.
Keng-Ling Wallin,Fredrik Wiklund,Tord Ångström,Frank Bergman,Ulf Stendahl,Göran Wadell,Göran Hallmans,Joakim Dillner +7 more
TL;DR: A single positive finding of HPV DNA in a Pap smear confers an increased risk of future invasive cervical cancer that is positive for the same type of virus as identified earlier.
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Rengaswamy Sankaranarayanan,Bhagwan M. Nene,Surendra S Shastri,Kasturi Jayant,Richard Muwonge,Atul Budukh,Sanjay Hingmire,Sylla G. Malvi,Ranjit Thorat,Ashok Kothari,Roshan F. Chinoy,Rohini Kelkar,Shubhada Kane,Sangeetha Desai,Vijay R Keskar,Raghevendra Rajeshwarkar,Nandkumar S Panse,Ketayun A. Dinshaw +17 more