Qin-Jing Pan1, Shang-Ying Hu2, Hui-Qin Guo3, Wen-Hua Zhang4, Xun Zhang3, Wen Chen2, Jian Cao3, Yong Jiang2, Fang-Hui Zhao2, You-Lin Qiao5. 1. Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China. Electronic address: pqjing@hotmail.com. 2. Department of Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China. 3. Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China. 4. Department of Gynecological Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China. 5. Department of Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China. Electronic address: qiaoy@cicams.ac.cn.
Abstract
OBJECTIVE: The objective of this study was to evaluate the impact of introducing HR-HPV testing in cytology regarding cervical cancer screening practice. METHODS: A pooled analysis of liquid-based cytology (LBC) and HR-HPV testing using data from 13 population-based cervical cancer screening studies conducted in China was performed. Participants (n=25,404) received LBC and HR-HPV testing. Women found to be positive on screening were referred for colposcopy and biopsy. The effectiveness of screening strategies that use: LBC with HR-HPV triage for atypical squamous cells of undetermined significance (ASC-US), HR-HPV testing with cytology triage for HPV positive tests, or LBC and HPV cotesting was compared with that of LBC screening alone. RESULTS: LBC with HR-HPV triage for ASC-US had similar sensitivity compared with LBC alone, but significantly increased specificity for both cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and CIN3 or worse (CIN3+) endpoints, and had the best balance between sensitivity and specificity among the strategies. LBC and HR-HPV cotesting had the highest sensitivity and negative predictive value (NPV) and could permit a safe extension of screening intervals. Through the use of an immediate colposcopy threshold of ASC-US or worse for HR-HPV positive women and the use of a raised threshold of low-grade squamous intraepithelial lesion (LSIL) or worse for HR-HPV negative women, LBC and HR-HPV cotesting could provide the same effectiveness as LBC testing with HR-HPV triage for ASC-US at baseline tests. CONCLUSIONS: The results of the current study support the use of the cervical cancer screening guidelines in China.
OBJECTIVE: The objective of this study was to evaluate the impact of introducing HR-HPV testing in cytology regarding cervical cancer screening practice. METHODS: A pooled analysis of liquid-based cytology (LBC) and HR-HPV testing using data from 13 population-based cervical cancer screening studies conducted in China was performed. Participants (n=25,404) received LBC and HR-HPV testing. Women found to be positive on screening were referred for colposcopy and biopsy. The effectiveness of screening strategies that use: LBC with HR-HPV triage for atypical squamous cells of undetermined significance (ASC-US), HR-HPV testing with cytology triage for HPV positive tests, or LBC and HPV cotesting was compared with that of LBC screening alone. RESULTS: LBC with HR-HPV triage for ASC-US had similar sensitivity compared with LBC alone, but significantly increased specificity for both cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and CIN3 or worse (CIN3+) endpoints, and had the best balance between sensitivity and specificity among the strategies. LBC and HR-HPV cotesting had the highest sensitivity and negative predictive value (NPV) and could permit a safe extension of screening intervals. Through the use of an immediate colposcopy threshold of ASC-US or worse for HR-HPV positive women and the use of a raised threshold of low-grade squamous intraepithelial lesion (LSIL) or worse for HR-HPV negative women, LBC and HR-HPV cotesting could provide the same effectiveness as LBC testing with HR-HPV triage for ASC-US at baseline tests. CONCLUSIONS: The results of the current study support the use of the cervical cancer screening guidelines in China.
Authors: Shang-Ying Hu; Aimée R Kreimer; Carolina Porras; Diego Guillén; Mario Alfaro; Teresa M Darragh; Mark H Stoler; Luis F Villegas; Rebecca Ocampo; Ana Cecilia Rodriguez; Mark Schiffman; Sabrina H Tsang; Douglas R Lowy; John T Schiller; John Schussler; Wim Quint; Mitchell H Gail; Joshua N Sampson; Allan Hildesheim; Rolando Herrero Journal: J Natl Cancer Inst Date: 2022-09-09 Impact factor: 11.816
Authors: Nicole G Campos; Mercy Mvundura; Jose Jeronimo; Francesca Holme; Elisabeth Vodicka; Jane J Kim Journal: BMJ Open Date: 2017-06-15 Impact factor: 2.692