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Safety of screening with Human papillomavirus testing for cervical cancer at three-year intervals in a high-risk population: experience from the LAMS study.
J Med Screen. 2008; 15(2):97-104.JM

Abstract

OBJECTIVES

To assess whether human papillomavirus (HPV) testing is a safe enough approach to warrant extension of the screening intervals of baseline Papanicolaou (Pap)-/HPV- women in low-income settings.

METHODS

Of the >1000 women prospectively followed up as part of the Latin American Screening (LAMS) Study in São Paulo, Campinas, Porto Alegre) and Buenos Aires, 470 women with both baseline cytology and Hybrid Capture 2 (HC2) results available were included in this analysis. These baseline Pap-negative and HC2- or HC2+ women were controlled at six-month intervals with colposcopy, HC2 and Pap to assess the cumulative risk of incident Pap smear abnormalities and their predictive factors.

RESULTS

Of the 470 women, 324 (68.9%) were high-risk HPV (hrHPV) positive and 146 (31.1%) were negative. Having two or more lifetime sex partners (odds ratio [OR] = 2.63; 95% CI 1.70-3.51) and women using hormonal contraception (OR = 2.21; 95% CI 1.40-3.51) were at increased risk for baseline hrHPV infection. Baseline hrHPV+ women had a significantly increased risk of incident abnormal Pap smears during the follow-up. Survival curves deviate from each other starting at month 24 onwards, when hrHPV+ women start rapidly accumulating incident Pap smear abnormalities, including atypical squamous cells (ASC) or worse (log-rank; P < 0.001), low-grade squamous intraepithelial lesions (LSIL) or worse (P < 0.001) and high-grade squamous intraepithelial lesions (HSIL) (P = 0.03). Among the baseline hrHPV- women, the acquisition of incident hrHPV during the follow-up period significantly increased the risk of incident cytological abnormalities (hazard ratio = 3.5; 95% CI 1.1-11.7).

CONCLUSION

These data implicate that HPV testing for hrHPV types might be a safe enough approach to warrant extension of the screening interval of hrHPV-/Pap-women even in low-resource settings. Although some women will inevitably contract hrHPV, the process to develop HSIL will be long enough to enable their detection at the next screening round (e.g. after three years).

Authors+Show Affiliations

Alexander Fleming, 848, Nova Campinas, Campinas, São Paulo, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18573778

Citation

Derchain, S F., et al. "Safety of Screening With Human Papillomavirus Testing for Cervical Cancer at Three-year Intervals in a High-risk Population: Experience From the LAMS Study." Journal of Medical Screening, vol. 15, no. 2, 2008, pp. 97-104.
Derchain SF, Sarian LO, Naud P, et al. Safety of screening with Human papillomavirus testing for cervical cancer at three-year intervals in a high-risk population: experience from the LAMS study. J Med Screen. 2008;15(2):97-104.
Derchain, S. F., Sarian, L. O., Naud, P., Roteli-Martins, C., Longatto-Filho, A., Tatti, S., Branca, M., Erzen, M., Serpa-Hammes, L., Matos, J., Gontijo, R. C., Bragança, J. F., Lima, T. P., Maeda, M. Y., Lörincz, A., Dores, G. B., Costa, S., Syrjänen, S., & Syrjänen, K. (2008). Safety of screening with Human papillomavirus testing for cervical cancer at three-year intervals in a high-risk population: experience from the LAMS study. Journal of Medical Screening, 15(2), 97-104. https://doi.org/10.1258/jms.2008.007061
Derchain SF, et al. Safety of Screening With Human Papillomavirus Testing for Cervical Cancer at Three-year Intervals in a High-risk Population: Experience From the LAMS Study. J Med Screen. 2008;15(2):97-104. PubMed PMID: 18573778.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety of screening with Human papillomavirus testing for cervical cancer at three-year intervals in a high-risk population: experience from the LAMS study. AU - Derchain,S F, AU - Sarian,L O, AU - Naud,P, AU - Roteli-Martins,C, AU - Longatto-Filho,A, AU - Tatti,S, AU - Branca,M, AU - Erzen,M, AU - Serpa-Hammes,L, AU - Matos,J, AU - Gontijo,R C, AU - Bragança,J F, AU - Lima,T P, AU - Maeda,M Y S, AU - Lörincz,A, AU - Dores,G B, AU - Costa,S, AU - Syrjänen,S, AU - Syrjänen,K, PY - 2008/6/25/pubmed PY - 2008/12/17/medline PY - 2008/6/25/entrez SP - 97 EP - 104 JF - Journal of medical screening JO - J Med Screen VL - 15 IS - 2 N2 - OBJECTIVES: To assess whether human papillomavirus (HPV) testing is a safe enough approach to warrant extension of the screening intervals of baseline Papanicolaou (Pap)-/HPV- women in low-income settings. METHODS: Of the >1000 women prospectively followed up as part of the Latin American Screening (LAMS) Study in São Paulo, Campinas, Porto Alegre) and Buenos Aires, 470 women with both baseline cytology and Hybrid Capture 2 (HC2) results available were included in this analysis. These baseline Pap-negative and HC2- or HC2+ women were controlled at six-month intervals with colposcopy, HC2 and Pap to assess the cumulative risk of incident Pap smear abnormalities and their predictive factors. RESULTS: Of the 470 women, 324 (68.9%) were high-risk HPV (hrHPV) positive and 146 (31.1%) were negative. Having two or more lifetime sex partners (odds ratio [OR] = 2.63; 95% CI 1.70-3.51) and women using hormonal contraception (OR = 2.21; 95% CI 1.40-3.51) were at increased risk for baseline hrHPV infection. Baseline hrHPV+ women had a significantly increased risk of incident abnormal Pap smears during the follow-up. Survival curves deviate from each other starting at month 24 onwards, when hrHPV+ women start rapidly accumulating incident Pap smear abnormalities, including atypical squamous cells (ASC) or worse (log-rank; P < 0.001), low-grade squamous intraepithelial lesions (LSIL) or worse (P < 0.001) and high-grade squamous intraepithelial lesions (HSIL) (P = 0.03). Among the baseline hrHPV- women, the acquisition of incident hrHPV during the follow-up period significantly increased the risk of incident cytological abnormalities (hazard ratio = 3.5; 95% CI 1.1-11.7). CONCLUSION: These data implicate that HPV testing for hrHPV types might be a safe enough approach to warrant extension of the screening interval of hrHPV-/Pap-women even in low-resource settings. Although some women will inevitably contract hrHPV, the process to develop HSIL will be long enough to enable their detection at the next screening round (e.g. after three years). SN - 0969-1413 UR - https://www.unboundmedicine.com/medline/citation/18573778/Safety_of_screening_with_Human_papillomavirus_testing_for_cervical_cancer_at_three_year_intervals_in_a_high_risk_population:_experience_from_the_LAMS_study_ L2 - http://journals.sagepub.com/doi/full/10.1258/jms.2008.007061?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -