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Cervical cancer screening by high risk HPV testing in routine practice: results at one year recall of high risk HPV-positive and cytology-negative women.

Abstract

OBJECTIVE

Cervical cancer screening by human papillomavirus (HPV) testing requires the use of additional triage and follow-up analyses. We evaluated women's compliance with and the performance of this strategy in a routine setting.

SETTING

Five cervical service screening programmes in North-East Italy.

METHODS

Eligible women aged 25-64 invited for a new screening episode underwent HPV testing for high risk types (hrHPV by Hybrid Capture 2) and cytology triage. Women with positive HPV and cytology results were referred for colposcopy; women with positive HPV but negative cytology results were referred to 1-year repeat hrHPV testing.

RESULTS

Of 46,694 women screened by HPV testing up to December 2011, 3,211 (6.9%) tested hrHPV positive; 45% of these had a positive triage cytology. Those with negative cytology were invited for 1-yr repeat testing. Compliance with invitation was 61.6% at baseline and 85.3% at 1-yr repeat. Rate of persistent hrHPV positivity was 58% (830/1,435). Colposcopy performed in women with a positive hrHPV test at 1-yr repeat accounted for 36% of all colposcopies performed within the screening programmes. Cumulatively, a histological high-grade lesion was detected in 276 women (5.9‰ detection rate), 234 at baseline (85%), and 42 (15%) at 1-yr repeat.

CONCLUSIONS

Compliance with hrHPV-based screening programmes was high both at baseline and at 1-yr repeat. Compared with the randomized trials, a higher proportion of triage cytology was read as positive, and only a small number of high-grade lesions were detected among the group of hrHPV positive cytology negative women who repeated testing 1-yr after baseline.

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  • Authors+Show Affiliations

    ,

    Immunology and Molecular Oncology Unit, Veneto Oncology Institute IOV IRCCS, Padova, Italy.

    , , , , , , , , , ,

    Source

    Journal of medical screening 21:1 2014 Mar pg 30-7

    MeSH

    Adult
    Cervical Intraepithelial Neoplasia
    Colposcopy
    Early Detection of Cancer
    Female
    Follow-Up Studies
    Humans
    Italy
    Mass Screening
    Middle Aged
    Papillomaviridae
    Papillomavirus Infections
    Predictive Value of Tests
    Sensitivity and Specificity
    Uterine Cervical Neoplasms

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    24488593

    Citation

    Del Mistro, Annarosa, et al. "Cervical Cancer Screening By High Risk HPV Testing in Routine Practice: Results at One Year Recall of High Risk HPV-positive and Cytology-negative Women." Journal of Medical Screening, vol. 21, no. 1, 2014, pp. 30-7.
    Del Mistro A, Frayle H, Ferro A, et al. Cervical cancer screening by high risk HPV testing in routine practice: results at one year recall of high risk HPV-positive and cytology-negative women. J Med Screen. 2014;21(1):30-7.
    Del Mistro, A., Frayle, H., Ferro, A., Callegaro, S., Del Sole, A., Stomeo, A., ... Zorzi, M. (2014). Cervical cancer screening by high risk HPV testing in routine practice: results at one year recall of high risk HPV-positive and cytology-negative women. Journal of Medical Screening, 21(1), pp. 30-7. doi:10.1177/0969141314522219.
    Del Mistro A, et al. Cervical Cancer Screening By High Risk HPV Testing in Routine Practice: Results at One Year Recall of High Risk HPV-positive and Cytology-negative Women. J Med Screen. 2014;21(1):30-7. PubMed PMID: 24488593.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cervical cancer screening by high risk HPV testing in routine practice: results at one year recall of high risk HPV-positive and cytology-negative women. AU - Del Mistro,Annarosa, AU - Frayle,Helena, AU - Ferro,Antonio, AU - Callegaro,Susanna, AU - Del Sole,Annamaria, AU - Stomeo,Anna, AU - Cirillo,Emanuela, AU - Fedato,Chiara, AU - Pagni,Silvana, AU - Barzon,Luisa, AU - Zorzi,Manuel, AU - ,, Y1 - 2014/01/31/ PY - 2014/2/4/entrez PY - 2014/2/4/pubmed PY - 2014/11/14/medline KW - HPV KW - follow-up KW - organized screening KW - triage SP - 30 EP - 7 JF - Journal of medical screening JO - J Med Screen VL - 21 IS - 1 N2 - OBJECTIVE: Cervical cancer screening by human papillomavirus (HPV) testing requires the use of additional triage and follow-up analyses. We evaluated women's compliance with and the performance of this strategy in a routine setting. SETTING: Five cervical service screening programmes in North-East Italy. METHODS: Eligible women aged 25-64 invited for a new screening episode underwent HPV testing for high risk types (hrHPV by Hybrid Capture 2) and cytology triage. Women with positive HPV and cytology results were referred for colposcopy; women with positive HPV but negative cytology results were referred to 1-year repeat hrHPV testing. RESULTS: Of 46,694 women screened by HPV testing up to December 2011, 3,211 (6.9%) tested hrHPV positive; 45% of these had a positive triage cytology. Those with negative cytology were invited for 1-yr repeat testing. Compliance with invitation was 61.6% at baseline and 85.3% at 1-yr repeat. Rate of persistent hrHPV positivity was 58% (830/1,435). Colposcopy performed in women with a positive hrHPV test at 1-yr repeat accounted for 36% of all colposcopies performed within the screening programmes. Cumulatively, a histological high-grade lesion was detected in 276 women (5.9‰ detection rate), 234 at baseline (85%), and 42 (15%) at 1-yr repeat. CONCLUSIONS: Compliance with hrHPV-based screening programmes was high both at baseline and at 1-yr repeat. Compared with the randomized trials, a higher proportion of triage cytology was read as positive, and only a small number of high-grade lesions were detected among the group of hrHPV positive cytology negative women who repeated testing 1-yr after baseline. SN - 1475-5793 UR - https://www.unboundmedicine.com/medline/citation/24488593/Cervical_cancer_screening_by_high_risk_HPV_testing_in_routine_practice:_results_at_one_year_recall_of_high_risk_HPV_positive_and_cytology_negative_women_ L2 - http://journals.sagepub.com/doi/full/10.1177/0969141314522219?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -