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Use of a high-risk human papillomavirus DNA test as the primary test in a cervical cancer screening programme: a population-based cohort study.
BJOG 2013; 120(10):1260-7; discussion 1267-8BJOG

Abstract

OBJECTIVE

To present the results of the first 2 years of a human papillomavirus (HPV) test-based screening programme outside the research context.

DESIGN

Population-based cohort study.

SETTING

A cervical service screening programme in Italy.

POPULATION

Women aged 25-64 years invited to screening from April 2009 to April 2011.

METHODS

Eligible women were invited to undergo an HPV test: those with a negative HPV test went on to the next screening episode; those with a positive HPV went on to triage with a Pap smear. Women with positive cytology (i.e. positive for atypical squamous cells of undetermined significance or worse, ASC-US+) were referred to colposcopy, whereas those with negative cytology were referred to repeat HPV testing 1 year later.

MAIN OUTCOME MEASURES

Participation rate, positivity at HPV and at triage, referral rate to colposcopy, positive predictive value for cervical intraepithelial neoplasia grade 2+ (CIN2+) at colposcopy, and detection rate for CIN2+.

RESULTS

Participation increased compared with the previous Pap programme (60.6 versus 43.9%). The HPV positivity rate was 7.0; 39.6% of Pap smears were scored as positive, and therefore 2.8% of the women screened were referred for immediate colposcopy. The compliance of women who scored positive for HPV and negative for Pap for repeat HPV testing at 12 months was 78.6%, and the HPV positivity rate was 56.6%. The overall referral rate to colposcopy was 4.6%. The overall detection rate for CIN2+ was 4.5 versus 1.5% of the Pap programme (25-34 years, 8.2%; 35+ years, 3.6%).

CONCLUSIONS

Compared with the traditional Pap test, the HPV programme recorded a higher response to invitation and an increased DR for CIN2+. The most critical aspects were the reading of cytology in women that were positive for HPV and the increased workload at colposcopy.

Authors+Show Affiliations

Veneto Tumour Registry, Istituto Oncologico Veneto IRCCS, Padua, Italy. manuel.zorzi@ioveneto.itNo 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

23786222

Citation

Zorzi, M, et al. "Use of a High-risk Human Papillomavirus DNA Test as the Primary Test in a Cervical Cancer Screening Programme: a Population-based Cohort Study." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 120, no. 10, 2013, pp. 1260-7; discussion 1267-8.
Zorzi M, Del Mistro A, Farruggio A, et al. Use of a high-risk human papillomavirus DNA test as the primary test in a cervical cancer screening programme: a population-based cohort study. BJOG. 2013;120(10):1260-7; discussion 1267-8.
Zorzi, M., Del Mistro, A., Farruggio, A., de'Bartolomeis, L., Frayle-Salamanca, H., Baboci, L., ... Ferro, A. (2013). Use of a high-risk human papillomavirus DNA test as the primary test in a cervical cancer screening programme: a population-based cohort study. BJOG : an International Journal of Obstetrics and Gynaecology, 120(10), pp. 1260-7; discussion 1267-8. doi:10.1111/1471-0528.12272.
Zorzi M, et al. Use of a High-risk Human Papillomavirus DNA Test as the Primary Test in a Cervical Cancer Screening Programme: a Population-based Cohort Study. BJOG. 2013;120(10):1260-7; discussion 1267-8. PubMed PMID: 23786222.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of a high-risk human papillomavirus DNA test as the primary test in a cervical cancer screening programme: a population-based cohort study. AU - Zorzi,M, AU - Del Mistro,A, AU - Farruggio,A, AU - de'Bartolomeis,L, AU - Frayle-Salamanca,H, AU - Baboci,L, AU - Bertazzo,A, AU - Cocco,P, AU - Fedato,C, AU - Gennaro,M, AU - Marchi,N, AU - Penon,M G, AU - Cogo,C, AU - Ferro,A, Y1 - 2013/06/21/ PY - 2013/02/20/accepted PY - 2013/6/22/entrez PY - 2013/6/22/pubmed PY - 2013/11/15/medline KW - Cervical cancer screening KW - HPV DNA test KW - human papillomavirus SP - 1260-7; discussion 1267-8 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 120 IS - 10 N2 - OBJECTIVE: To present the results of the first 2 years of a human papillomavirus (HPV) test-based screening programme outside the research context. DESIGN: Population-based cohort study. SETTING: A cervical service screening programme in Italy. POPULATION: Women aged 25-64 years invited to screening from April 2009 to April 2011. METHODS: Eligible women were invited to undergo an HPV test: those with a negative HPV test went on to the next screening episode; those with a positive HPV went on to triage with a Pap smear. Women with positive cytology (i.e. positive for atypical squamous cells of undetermined significance or worse, ASC-US+) were referred to colposcopy, whereas those with negative cytology were referred to repeat HPV testing 1 year later. MAIN OUTCOME MEASURES: Participation rate, positivity at HPV and at triage, referral rate to colposcopy, positive predictive value for cervical intraepithelial neoplasia grade 2+ (CIN2+) at colposcopy, and detection rate for CIN2+. RESULTS: Participation increased compared with the previous Pap programme (60.6 versus 43.9%). The HPV positivity rate was 7.0; 39.6% of Pap smears were scored as positive, and therefore 2.8% of the women screened were referred for immediate colposcopy. The compliance of women who scored positive for HPV and negative for Pap for repeat HPV testing at 12 months was 78.6%, and the HPV positivity rate was 56.6%. The overall referral rate to colposcopy was 4.6%. The overall detection rate for CIN2+ was 4.5 versus 1.5% of the Pap programme (25-34 years, 8.2%; 35+ years, 3.6%). CONCLUSIONS: Compared with the traditional Pap test, the HPV programme recorded a higher response to invitation and an increased DR for CIN2+. The most critical aspects were the reading of cytology in women that were positive for HPV and the increased workload at colposcopy. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/23786222/Use_of_a_high_risk_human_papillomavirus_DNA_test_as_the_primary_test_in_a_cervical_cancer_screening_programme:_a_population_based_cohort_study_ L2 - https://doi.org/10.1111/1471-0528.12272 DB - PRIME DP - Unbound Medicine ER -