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 value of p16ink4a expression by fluorescence in situ hybridization in triage for high risk HPV positive in cervical cancer screening
TL;DR: FISH detection specific to p16ink4a presents a high consistency with cytologic grading and has a higher accuracy for predicting high grade CIN than cytology in high risk HPV positive women.
Journal ArticleDOI
Cytology of the vulva: feasibility and preliminary results of a new brush.
L C G van den Einden,Johanna M. M. Grefte,I.A.M. van der Avoort,J. E. M. Vedder,L.C.L.T. van Kempen,L.C.L.T. van Kempen,Leon F.A.G. Massuger,J.A. de Hullu +7 more
TL;DR: Vulvar brush cytology is feasible and may be a first step in the development of a triage instrument to determine whether subsequent biopsy of a clinically (pre)malignant lesion is necessary.
Journal ArticleDOI
Challenges in risk estimation using routinely collected clinical data: The example of estimating cervical cancer risks from electronic health-records
Rebecca Landy,Li C. Cheung,Mark Schiffman,Julia C. Gage,Noorie Hyun,Nicolas Wentzensen,Walter Kinney,Philip E. Castle,Barbara Fetterman,Nancy E. Poitras,Thomas Lorey,Peter Sasieni,Hormuzd A. Katki +12 more
TL;DR: It is demonstrated that methods for right-censored data, such as Kaplan-Meier, result in biased estimates of disease risks when applied to interval- censoring data,such as screening programs using EHR data.
Journal ArticleDOI
Assessment of the effectiveness of HPV16/18 infection referred for colposcopy in cervical cancer screening in Northwest of China.
Qian Zhang,Minyi Zhao,Di Cao,Xing Wei,Li Wang,Yang Li,Ting Yang,Juan Zhao,Meili Pei,Hongran Jia,Siyu Cao,Shimin Quan,Xiaofeng Yang +12 more
TL;DR: Primary HPV16/18 detection has high sensitivity and negative predictive value in cervical cancer screening and the strategy for women with HPV16 and HPV18 infection referral to colposcopy is efficient and feasible in northwestern region of China.
Journal ArticleDOI
Strategies to reach marginalized women for cervical cancer screening: A qualitative study of stakeholder perspectives.
TL;DR: Canadian cervical cancer screening stakeholders should collaborate to identify the knowledge gaps that researchers should address and leverage the existing literature to implement tailored, patient-centred alternative cervical screening strategies.
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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