Human papillomavirus testing versus cytology in primary cervical cancer screening: End-of-study and extended follow-up results from the Canadian cervical cancer screening trial
Sandra D. Isidean,Marie-Hélène Mayrand,Agnihotram V. Ramanakumar,Laura Gilbert,Stephanie L Reid,Isabel Rodrigues,Alex Ferenczy,Sam Ratnam,François Coutlée,Eduardo L. Franco +9 more
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TLDR
HPV‐based cervical screening may allow for greater disease detection than cytology‐based screening and permit safe extensions of screening intervals; genotype‐specific testing could provide further improvement in the positive predictive value of such screening.Abstract:
The Canadian Cervical Cancer Screening Trial was a randomized controlled trial comparing the performance of human papillomavirus (HPV) testing and Papanicolaou cytology to detect cervical intraepithelial neoplasia of grades 2 or worse (CIN2+) among women aged 30–69 years attending routine cervical cancer screening in Montreal and St. John's, Canada (n = 10,154). We examined screening and prognostic values of enrollment cytologic and HPV testing results. Extended follow-up data were available for St. John's participants (n = 5,754; 501,682.6 person-months). HPV testing detected more CIN2+ than cytology during protocol-defined (82.9 vs. 44.4%) and extended (54.2 vs. 19.3%) follow-up periods, respectively. Three-year risks ranged from 0.87% (95% CI: 0.37–2.05) for HPV-/Pap- women to 35.77% (95% CI: 25.88–48.04) for HPV+/Pap+ women. Genotype-specific risks ranged from 0.90% (95% CI: 0.40–2.01) to 43.84% (95% CI: 32.42–57.24) among HPV− and HPV16+ women, respectively, exceeding those associated with Pap+ or HPV+ results taken individually or jointly. Ten-year risks ranged from 1.15% (95% CI: 0.60–2.19) for HPV−/Pap− women to 26.05% (95% CI: 15.34–42.13) for HPV+/Pap+ women and genotype-specific risks ranged from 1.13% (95% CI: 0.59–2.14) to 32.78% (95% CI: 21.15–48.51) among women testing HPV− and HPV16+, respectively. Abnormal cytology stratified risks most meaningfully for HPV+ women. Primary HPV testing every 3 years provided a similar or greater level of reassurance against disease risks as currently recommended screening strategies. HPV-based cervical screening may allow for greater disease detection than cytology-based screening and permit safe extensions of screening intervals; genotype-specific testing could provide further improvement in the positive predictive value of such screening.read more
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Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing.
TL;DR: This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe and the most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are presented.
Journal ArticleDOI
Effect of organised cervical cancer screening on cervical cancer mortality in Europe: a systematic review.
Erik E.L. Jansen,Nadine Zielonke,Andrea Gini,Ahti Anttila,Nereo Segnan,Zoltán Vokó,Urška Ivanuš,Martin McKee,Harry J. de Koning,Inge M.C.M. de Kok,Piret Veerus,Sirpa Heinävaara,Tytti Sarkeala,Marcell Csanádi,János György Pitter,György Széles,Silvia Minozzi,Carlo Senore,Marjolein van Ballegooijen,Inge Driesprong de Kok,Eveline A.M. Heijnsdijk,Erik E.L. Jansen,Harry J. de Koning,Iris Lansdorp – Vogelaar,Nicolien T. van Ravesteyn,Katja Jarm,Dominika Novak Mlakar,Maja Primic-Žakelj,Jennifer Priaulx +28 more
TL;DR: Evidence is provided that organised CC screening reduces CC mortality in those parts of Europe where CC screening was implemented and monitored, and although data were lacking in Southern and Eastern Europe, the effect size varied between countries and studies.
Journal ArticleDOI
Introduction of molecular HPV testing as the primary technology in cervical cancer screening: Acting on evidence to change the current paradigm.
Joseph E. Tota,James Bentley,Jennifer Blake,François Coutlée,Máire A. Duggan,Alex Ferenczy,Eduardo L. Franco,Michael Fung-Kee-Fung,Walter H. Gotlieb,Marie-Hélène Mayrand,Meg McLachlin,Joan Murphy,Gina Ogilvie,Sam Ratnam +13 more
TL;DR: A group of clinical experts and researchers in cervical cancer prevention from across Canada have jointly authored this comprehensive examination of the evidence to implement HPV primary screening to create a common understanding among policy makers, agencies, clinicians, researchers and other stakeholders about the evidence.
Journal ArticleDOI
Cervical screening with primary HPV testing or cytology in a population of women in which those aged 33 years or younger had previously been offered HPV vaccination: Results of the Compass pilot randomised trial.
Karen Canfell,Karen Canfell,Karen Canfell,Michael Caruana,Val Gebski,Jessica Darlington-Brown,Stella Heley,Julia M.L. Brotherton,Dorota M. Gertig,Chloe J Jennett,Annabelle Farnsworth,Jeffrey Tan,Jeffrey Tan,C. David Wrede,C. David Wrede,Philip E. Castle,Marion Saville +16 more
TL;DR: The main outcomes were colposcopy referral and detected CIN2+ rates at baseline screening and difference in referral rate in LBC versus all HPV-screened women, with p = 0.62 between HPV screening groups.
Journal ArticleDOI
Patient-derived organoids model cervical tissue dynamics and viral oncogenesis in cervical cancer.
Kadi Lõhmussaar,Rurika Oka,Jose Espejo Valle-Inclan,Milou H.H. Smits,Hila Wardak,Jeroen Korving,Harry Begthel,Natalie Proost,Marieke van de Ven,Onno Kranenburg,Trudy N. Jonges,Ronald P. Zweemer,Sebastiaan Veersema,Ruben van Boxtel,Hans Clevers +14 more
TL;DR: In this paper, a long-term culturing protocol for ecto-and endocervical epithelia was described that generates 3D organoids that stably recapitulate the two tissues of origin.
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