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 Article
Cervical Cancer Screening in France
TL;DR: 5. Human papillomavirus DNA testing for the detection of cervical intraepithelial neoplasia grade 3 and cancer: 5-year follow-up of a randomised controlled implementation trial.
OtherDOI
Cervical cancer screening: An exemplar of a population screening programme, and cervical cancer prevention
Albert Singer,Ashfaq M. Khan +1 more
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DECENA - cervical cancer primary screening program in Vojvodina
Jelka Rajovic,Ljiljana Andrijevic,Robert Fajka,Attila Fenyvesi,Dragan Malobabic,Dragomir Cuk,Jelena Korovljev,Vesna Kmezic,Laslo Stajer,Aleksandar Barisic,Adela Masic +10 more
TL;DR: Hc2 DNA test for detection of 13 oncogenic human papillomavirus genotypes is a real partner to cytology, concerning improvement and better detection of premalignant and malignant cervical diseases and HPV status is important additional parameter, especially when making decision about the most adequate treatment protocols.
Journal ArticleDOI
ACOG guidelines on cervical screening: a step in the right direction
TL;DR: There is certainly no ‘good evidence’ to recommend cervical screening beginning at age 21, and it is reasonable to discontinue cervical screening between 65 years and 70 years of age in women who have three or more negative cytology results in a row.
Journal ArticleDOI
Estudio comparativo de conizaciones realizadas en la provincia de Segovia antes y después del uso del test del virus del papiloma humano (2007-2010)
Virginia Sanz García,Mailen Rey Zaila,Ana Isabel Gómez Calvo,Juan Ignacio Bermejo Aycart,Fernando Izquierdo González +4 more
TL;DR: El VPP del cribado de cancer de cervix ha aumentado en nuestra provincia with el test of VPH sin aumentar el numero of conizaciones, aunque sin significacion estadistica.
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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