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
TLDR
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.Abstract:
Several studies suggest that HPV testing is more sensitive than cytology in primary cervical screening. These studies had different designs and were reported in different ways. Individual patient data were collected for all European and North American studies in which cytology was routinely performed and HPV testing was included as an additional parallel test. More than 60,000 women were included. The sensitivity and specificity of HPV testing were compared with routine cytology, both overall and for ages <35, 35–49 and 50+. The age-specific prevalence of high risk HPV (hr-HPV) was also analysed. HPV testing was substantially more sensitive in detecting CIN2+ than cytology (96.1% vs. 53.0%) but less specific (90.7% vs. 96.3%). The sensitivity of HPV testing was similar in all studies carried out in different areas of Europe and North America, whereas the sensitivity of cytology was highly variable. HPV sensitivity was uniformly high at all ages, whereas the sensitivity of cytology was substantially better in women over the age of 50 than in younger women (79.3% vs. 59.6%). The specificity of both tests increased with age. Positivity rates for HPV testing in women without high-grade CIN were region dependent. These results support the use of HPV testing as the sole primary screening test, with cytology reserved for women who test HPV positive. Large demonstration projects are needed to fully evaluate this strategy. © 2006 Wiley-Liss, Inc.read more
Citations
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Journal ArticleDOI
The expanded use of HPV testing in gynecologic practice per ASCCP-guided management requires the use of well-validated assays.
Journal ArticleDOI
High-risk HPV type-specific clearance rates in cervical screening
Nicole W.J. Bulkmans,Johannes Berkhof,Saskia Bulk,Maaike C G Bleeker,F.J. van Kemenade,Lawrence Rozendaal,Peter J.F. Snijders,Chris J.L.M. Meijer +7 more
TL;DR: The type-specific differences in clearance rates indicate the potential value of hrHPV genotyping in screening programs and support close surveillance of women with HPV16 and are inconclusive for surveillance of Women with HPV18, HPV31, and HPV33.
Journal ArticleDOI
A multicountry evaluation of careHPV testing, visual inspection with acetic acid, and papanicolaou testing for the detection of cervical cancer.
Jose Jeronimo,Pooja Bansil,Jeanette Lim,Roger Peck,Proma Paul,Juan Jose Amador,Florence Mirembe,Josaphat Byamugisha,Usha Rani Poli,L Satyanarayana,Smita Asthana +10 more
TL;DR: CareHPV performed well in large multicountry demonstration studies conducted in resource-limited settings that have not previously been conducted this type of testing; its sensitivity using cervical samples or vaginal self-collected samples was better than VIA or Papanicolaou test.
Journal ArticleDOI
Comparison of seven tests for high-grade cervical intraepithelial neoplasia in women with abnormal smears: the Predictors 2 study.
Anne Szarewski,David Mesher,Louise Cadman,Janet Austin,Lesley Ashdown-Barr,Linda Ho,George Terry,Stuart Liddle,Martin Young,Mark H. Stoler,Julie McCarthy,Corrina Wright,Christine Bergeron,William P Soutter,Deirdre Lyons,Jack Cuzick +15 more
TL;DR: This study confirms that, in a referral setting, HPV testing by a number of different tests provides high sensitivity for high-grade disease and further work is needed to confirm these findings in a routine screening setting.
Journal ArticleDOI
Role of human papillomaviruses in carcinogenesis.
TL;DR: The demonstration that high-risk HPV types are the etiological agents of cervical cancer allowed the implementation in the clinical routine of novel screening strategies for cervical lesions, as well as the development of a very efficient prophylactic vaccine.
References
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Journal ArticleDOI
Human papillomavirus is a necessary cause of invasive cervical cancer worldwide.
Jan M. M. Walboomers,M. V. Jacobs,M. M. Manos,Franz X. Bosch,J. A. Kummer,Keerti V. Shah,Peter J.F. Snijders,Julian Peto,Chris J.L.M. Meijer,Nubia Muñoz +9 more
TL;DR: The presence of HPV in virtually all cervical cancers implies the highest worldwide attributable fraction so far reported for a specific cause of any major human cancer, and the rationale for HPV testing in addition to, or even instead of, cervical cytology in routine cervical screening.
Journal ArticleDOI
Natural history of cervical human papillomavirus infection in young women: a longitudinal cohort study
Ciaran B J Woodman,Stuart Collins,Heather Winter,Andrew Bailey,John Ellis,Pat Prior,Marie Yates,Terry P. Rollason,Lawrence S. Young +8 more
TL;DR: The findings suggest that attempts to exploit the association between cervical neoplasia and HPV infection to improve effectiveness of cervical screening programmes might be undermined by the limited inferences that can be drawn from the characterisation of a woman's HPV status at a single point in time, and the short lead time gained by its detection.
Journal ArticleDOI
Relation of human papilloma virus status to cervical lesions and consequences for cervical-cancer screening: a prospective study
M A E Nobbenhuis,Jan M. M. Walboomers,Theo J.M. Helmerhorst,Lawrence Rozendaal,A. J. Remmink,Elle K.J. Risse,Hans C. van der Linden,Feja J. Voorhorst,Peter Kenemans,Chris J.L.M. Meijer +9 more
TL;DR: Persistent infection with high-risk human papillomavirus is necessary for development and maintenance of cervical intraepithelial neoplasia CIN 3, and all women with severe dyskaryosis should be referred to gynaecologists, whereas women with mild to moderate dysKaryosis ought to be referred only after a second positive test for high- risk human papillsomav virus at 6 months.
Journal ArticleDOI
Trends in mortality from cervical cancer in the nordic countries: association with organised screening programmes
TL;DR: Investigation of time trends in mortality from cervical cancer in Denmark, Finland, Iceland, Norway, and Sweden since the early 1950s supports the conclusion that organised screening programmes have had a major impact on the reduction in mortality in the Nordic countries.
Journal ArticleDOI
Management of women who test positive for high-risk types of human papillomavirus: The HART study
Jack Cuzick,Anne Szarewski,Heather Cubie,G Hulman,Henry C Kitchener,David Luesley,Euphemia McGoogan,Usha Menon,George Terry,Robert Edwards,Claire Brooks,Mina Desai,C Gie,Linda Lee Ho,Ian Jacobs,C Pickles,Peter Sasieni +16 more
TL;DR: Comparison of the detection rate and positive predictive values of HPV assay with cytology and the best management strategy for HPV-positive women found HPV testing was more sensitive than borderline or worse cytology but less specific for detecting CIN2+.
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