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Liquid-based cytology and human papillomavirus testing: a pooled analysis using the data from 13 population-based cervical cancer screening studies from China.
Gynecol Oncol 2014; 133(2):172-9GO

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.

Authors+Show Affiliations

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.Department of Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China.Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China.Department of Gynecological Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China.Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China.Department of Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China.Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China.Department of Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China.Department of Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, People's Republic of China.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.

Pub Type(s)

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

Language

eng

PubMed ID

24631450

Citation

Pan, Qin-Jing, et al. "Liquid-based Cytology and Human Papillomavirus Testing: a Pooled Analysis Using the Data From 13 Population-based Cervical Cancer Screening Studies From China." Gynecologic Oncology, vol. 133, no. 2, 2014, pp. 172-9.
Pan QJ, Hu SY, Guo HQ, et al. Liquid-based cytology and human papillomavirus testing: a pooled analysis using the data from 13 population-based cervical cancer screening studies from China. Gynecol Oncol. 2014;133(2):172-9.
Pan, Q. J., Hu, S. Y., Guo, H. Q., Zhang, W. H., Zhang, X., Chen, W., ... Qiao, Y. L. (2014). Liquid-based cytology and human papillomavirus testing: a pooled analysis using the data from 13 population-based cervical cancer screening studies from China. Gynecologic Oncology, 133(2), pp. 172-9. doi:10.1016/j.ygyno.2014.03.008.
Pan QJ, et al. Liquid-based Cytology and Human Papillomavirus Testing: a Pooled Analysis Using the Data From 13 Population-based Cervical Cancer Screening Studies From China. Gynecol Oncol. 2014;133(2):172-9. PubMed PMID: 24631450.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Liquid-based cytology and human papillomavirus testing: a pooled analysis using the data from 13 population-based cervical cancer screening studies from China. AU - Pan,Qin-Jing, AU - Hu,Shang-Ying, AU - Guo,Hui-Qin, AU - Zhang,Wen-Hua, AU - Zhang,Xun, AU - Chen,Wen, AU - Cao,Jian, AU - Jiang,Yong, AU - Zhao,Fang-Hui, AU - Qiao,You-Lin, Y1 - 2014/03/11/ PY - 2014/01/08/received PY - 2014/02/28/revised PY - 2014/03/05/accepted PY - 2014/3/18/entrez PY - 2014/3/19/pubmed PY - 2014/6/13/medline KW - Cervical cancer KW - HR-HPV KW - Liquid-based cytology KW - Population-based KW - Screening SP - 172 EP - 9 JF - Gynecologic oncology JO - Gynecol. Oncol. VL - 133 IS - 2 N2 - 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. SN - 1095-6859 UR - https://www.unboundmedicine.com/medline/citation/24631450/Liquid_based_cytology_and_human_papillomavirus_testing:_a_pooled_analysis_using_the_data_from_13_population_based_cervical_cancer_screening_studies_from_China_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-8258(14)00240-6 DB - PRIME DP - Unbound Medicine ER -