AIM: To determine cross-sectional validity of primary human papillomavirus (HPV) screening in comparison to cytological screening. METHODS:During 2003-2004, 61,149 women were individually randomised to screening with a test for oncogenic HPV DNA or to conventional cytological screening within the Finnish cervical screening programme. RESULTS: For HPV screening, cross-sectional relative sensitivity for cervical intraepithelial neoplasia (CIN) or cancer was 1.58 (95 % confidence interval 1.19-2.09) in comparison to cytology. At the level of CIN 3 or cancer no increase in relative sensitivity was observed. Cross-sectional specificity estimates for the screening arms were comparable, but the specificity of screening with sole HPV DNA test was clearly inferior. CONCLUSIONS: Primary HPV screening with cytology triage finds more CIN lesions compared to conventional screening but mild lesions are overrepresented. This is likely to result in overdiagnosis since most mild lesions are regressive.
RCT Entities:
AIM: To determine cross-sectional validity of primary human papillomavirus (HPV) screening in comparison to cytological screening. METHODS: During 2003-2004, 61,149 women were individually randomised to screening with a test for oncogenic HPV DNA or to conventional cytological screening within the Finnish cervical screening programme. RESULTS: For HPV screening, cross-sectional relative sensitivity for cervical intraepithelial neoplasia (CIN) or cancer was 1.58 (95 % confidence interval 1.19-2.09) in comparison to cytology. At the level of CIN 3 or cancer no increase in relative sensitivity was observed. Cross-sectional specificity estimates for the screening arms were comparable, but the specificity of screening with sole HPV DNA test was clearly inferior. CONCLUSIONS: Primary HPV screening with cytology triage finds more CIN lesions compared to conventional screening but mild lesions are overrepresented. This is likely to result in overdiagnosis since most mild lesions are regressive.
Authors: Anne Szarewski; David Mesher; Louise Cadman; Janet Austin; Lesley Ashdown-Barr; Linda Ho; George Terry; Stuart Liddle; Martin Young; Mark Stoler; Julie McCarthy; Corrina Wright; Christine Bergeron; W P Soutter; Deirdre Lyons; Jack Cuzick Journal: J Clin Microbiol Date: 2012-03-14 Impact factor: 5.948
Authors: Gina S Ogilvie; Dirk J van Niekerk; Mel Krajden; Ruth E Martin; Thomas G Ehlen; Kathy Ceballos; Stuart J Peacock; Laurie W Smith; Lisa Kan; Darrel A Cook; Wendy Mei; Gavin C E Stuart; Eduardo L Franco; Andrew J Coldman Journal: BMC Cancer Date: 2010-03-24 Impact factor: 4.430
Authors: Gina S Ogilvie; Laurie W Smith; Dirk J van Niekerk; Fareeza Khurshed; Mel Krajden; Mona Saraiya; Vivek Goel; Barbara K Rimer; Sandra B Greene; Suzanne Hobbs; Andrew J Coldman; Eduardo L Franco Journal: Int J Cancer Date: 2013-07-16 Impact factor: 7.396
Authors: Ahti Anttila; Laura Kotaniemi-Talonen; Maarit Leinonen; Matti Hakama; Pekka Laurila; Jussi Tarkkanen; Nea Malila; Pekka Nieminen Journal: BMJ Date: 2010-04-27