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 -