Identification of ideal strategy of cervical cancer screening in Japan based on Fukui cervical cancer screening study.

e17025 Background:The estimated age-standardized incidence rate for cervical cancer is higher in Japan than in North America and the UK. It is important to improve cancer screening. The introduction of HPV testing with cytology for triage of those that test positive for cervical cancer screening has been challenging. The Fukui Cervical Cancer Screening (FCCS) study was designed to determine the best cervical cancer screening method in the Japanese population. We performed a subanalysis using baseline data of FCCS study to determine the performance of cytology, the human papillomavirus (HPV) testing and cotesting with cytology and HPV testing, and to evaluate whether the stratification of HPV16, HPV18, and 12 other hrHPV types appropriately balances risks and harms in the Japanese cancer screening population. Methods:The study enrolled 7,584 women aged 25 years or older undergoing routine screening. All women underwent liquid-based cytology (LBC) and cobas HPV testing. Women with abnormal cytology regardless of the HPV status, women with positive hrHPV results regardless of cytology results, and women randomly selected from among those with normal cytology and negative hrHPV results were referred for colposcopy. Results:The prevalence of hrHPV, HPV16, and HPV18 was 6.8%, 1.2%, and 0.5%, respectively. The estimated sensitivities for cervical intraepithelial neoplasia (CIN) 2 or worse for cytology, HPV testing, and cotesting with cytology and HPV testing were 71%, 92%, and 100%, respectively. The estimated positive predictive values for cytology, HPV testing, and cotesting with cytology and HPV testing were 33%, 21% and 21%, respectively. Using a strategy whereby those with abnormal cytology or positive HPV16 genotype undergo colposcopy and biopsy results in a sensitivity of 85% and a positive predictive value of 33%. This strategy results in improved sensitivity while at the same time maintains the positive predictive value compared to screening with cytology alone. Conclusions:Baseline data from the FCCS study suggests that strategy of using colposcopy for women with abnormal cytology and/or HPV16 positivity appropriately balances risks and harms for Japanese women. Clinical trial information: UMIN000025977.

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Performance of HPV16/18 in Triage of Cytological Atypical Squamous Cells of Undetermined Significance

Analytical Cellular Pathology ◽

10.1155/2019/4324710 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Xiaoqin Cao ◽

Shuzheng Liu ◽

Manman Jia ◽

Hongmin Chen ◽

Dongmei Zhao ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Predictive Value ◽

Statistical Tests ◽

Predictive Values ◽

Squamous Cells ◽

Link Type ◽

Hpv Test ◽

Undetermined Significance

Context. Human papillomavirus (HPV) testing is widely used in cervical cancer screening in women; however, its efficiency in triaging women with atypical squamous cells of undetermined significance (ASC-US) needs to be validated. Objective. To evaluate the performance of HPV16/18 in the triage of women with ASC-US. Methods. Women presenting for routine cervical cancer screening had cervical specimens collected, with which both liquid-based cytology (LBC) and hrHPVs were examined; those with ASC-US cytology underwent colposcopy. HPV16/18 and 12 other types were tested with domestic hybridization capture and chemiluminescence signal amplification (DH3). Performance characteristics of HPV test (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for identification of cervical intraepithelium neoplasma (CIN) grade 2 or worse (CIN2+), and CIN grade 3 or worse (CIN3+)) were determined using standard statistical tests. Results. 317 women with ASC-US were eligible for the study. HrHPV prevalence was 15.77% (50/317); HPV16/18 prevalence was 3.61% (20/317). Sensitivity and specificity of HPV16/18 for detection of CIN 2+ were 64.71% and 97% and 64.29% and 96.37% for detection of CIN 3+, respectively. The positive predictive values (PPVs) and negative predictive values (NPVs) of HPV16/18 were 55.00% and 97.98% for CIN2+ and 45.00% and 98.32% for CIN3+, respectively. Conclusion. HPV16/18 can be considered as an effective method to triage women with ASC-US as its good clinical performance. Trial Registration. This trial is registered with Henan Cancer Hospital Medical Ethics Committee on July 5, 2016 (http://www.anti-cancer.com.cn), with registry no.: 2016037.

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Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing

Viruses ◽

10.3390/v10120729 ◽

2018 ◽

Vol 10 (12) ◽

pp. 729 ◽

Cited By ~ 42

Author(s):

Andreas Chrysostomou ◽

Dora Stylianou ◽

Anastasia Constantinidou ◽

Leondios Kostrikis

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Hpv Vaccination ◽

Screening Method ◽

Population Based ◽

Screening Tests ◽

Screening Methods ◽

Hpv Testing ◽

Screening Programs

Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.

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Quantification of intracellular HPV E6/E7 mRNA expression increases the specificity and positive predictive value of cervical cancer screening compared to HPV DNA

Gynecologic Oncology ◽

10.1016/j.ygyno.2010.09.013 ◽

2011 ◽

Vol 120 (1) ◽

pp. 89-93 ◽

Cited By ~ 51

Author(s):

Gerald Coquillard ◽

Bibiana Palao ◽

Bruce K. Patterson

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Positive Predictive Value ◽

Mrna Expression ◽

Cervical Cancer Screening ◽

Predictive Value ◽

Hpv Dna ◽

Hpv E6

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Evaluation of Liquid Based Cytology (LBC) and Conventional Pap’s Smear Test as Methods of Cervical Cancer Screening

International Journal of Human and Health Sciences (IJHHS) ◽

10.31344/ijhhs.v6i1.374 ◽

2022 ◽

Vol 6 (1) ◽

pp. 36

Author(s):

Mehdi Ashik Chowdhury ◽

Asim Ranjan Barua ◽

- Asaduzzaman ◽

Mohammad Mahabubul Hoque ◽

DM Arifur Rahman

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Cervical Cancer Screening ◽

Predictive Value ◽

Pap Smear ◽

Molecular Techniques ◽

Smear Preparation ◽

Liquid Based Cytology

Background: Cervical cancer screening can actually prevent most cervical cancers and also facilitates early detection which allows fruitful treatment.Objective: To evaluate and compare the efficacy of Liquid-based cytology (LBC) with conventional Pap smear test.Methods: This crosssectional study was conducted between March 2015 and June 2017. A total of 72 women participated in this study attending the Out-Patient Department (OPD) of Gynaecology (Colposcopy Clinic) of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, for VIA test. The smears prepared by the conventional Pap smear method and Liquid-based cytology method were observed by two independent observers in Department of Pathology of the same institution.Results: The mean age of the patients was 40.22±12.29 years. Considering histopathology as gold standard, in conventional Pap smear preparation our data suggested its sensitivity 87.5%, specificity 92.2%, accuracy 91.7%, positive predictive value 58.3% and negative predictive value 98.3%. In contrast, in Liquid-based cytology, we found its sensitivity 75.0%, specificity 90.6%, accuracy 88.9%, positive predictive value 50.0% and negative predictive value 96.7%.Conclusion: LBC has practical advantages over conventional preparation by producing monolayer of cells, smaller area to screen, reproducibility and availability of doing adjunct molecular techniques from residual sample. However, conventional preparation shows better sensitivity and positive predictive value and almost similar specificity, negative predictive value and accuracy with LBC.International Journal of Human and Health Sciences Vol. 06 No. 01 January’22 Page: 36-40

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Evaluation of the Clinical Performance of the HPV-Risk Assay Using the VALGENT-3 Panel

Journal of Clinical Microbiology ◽

10.1128/jcm.01282-17 ◽

2017 ◽

Vol 55 (12) ◽

pp. 3544-3551 ◽

Cited By ~ 20

Author(s):

N. J. Polman ◽

A. Oštrbenk ◽

L. Xu ◽

P. J. F. Snijders ◽

C. J. L. M. Meijer ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Clinical Performance ◽

Intraepithelial Neoplasia ◽

Relative Sensitivity ◽

Hpv Testing ◽

Abnormal Cytology ◽

Cervical Intraepithelial Neoplasia Grade ◽

Relative Specificity

ABSTRACTHuman papillomavirus (HPV) testing is increasingly being incorporated into cervical cancer screening. The Validation of HPV Genotyping Tests (VALGENT) is a framework designed to evaluate the clinical performance of various HPV tests relative to that of the validated and accepted comparator test in a formalized and uniform manner. The aim of this study was to evaluate the clinical performance of the HPV-Risk assay with samples from the VALGENT-3 panel and to compare its performance to that of the clinically validated Hybrid Capture 2 assay (HC2). The VALGENT-3 panel comprises 1,300 consecutive samples from women participating in routine cervical cancer screening and is enriched with 300 samples from women with abnormal cytology. DNA was extracted from original ThinPrep PreservCyt medium aliquots, and HPV testing was performed using the HPV-Risk assay by investigators blind to the clinical data. HPV prevalence was analyzed, and the clinical performance of the HPV-Risk assay for the detection of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) and CIN2 or worse (CIN2+) relative to the performance of HC2 was assessed. The sensitivity of the HPV-Risk assay for the detection of CIN3+ was similar to that of HC2 (relative sensitivity, 1.00; 95% confidence interval [CI], 0.95 to 1.05;P= 1.000), but the specificity of the HPV-Risk assay was significantly higher than that of HC2 (relative specificity, 1.02; 95% CI, 1.01 to 1.04;P< 0.001). For the detection of CIN2+, similar results were obtained, with the relative sensitivity being 0.98 (95% CI, 0.93 to 1.02;P= 0.257) and the relative specificity being 1.02 (95% CI, 1.01 to 1.03;P< 0.001). The performance of the HPV-Risk assay for the detection of CIN3+ and CIN2+ was noninferior to that of HC2, with allPvalues being ≤0.006. In conclusion, the HPV-Risk assay demonstrated noninferiority to the clinically validated HC2 by the use of samples from the VALGENT-3 panel for test validation and comparison.

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Cervical cancer screening by conventional Pap smear versus liquid based cytology

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v14i2.28435 ◽

2019 ◽

Vol 14 (2) ◽

pp. 22-25

Author(s):

Subi Basnyat ◽

Gehanath Baral ◽

Karishma Malla

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Positive Predictive Value ◽

Cervical Cancer Screening ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Pap Smear ◽

Premalignant Lesions ◽

Cross Sectional ◽

Liquid Based Cytology

Aims: To evaluate Liquid Based Cytology (LBC) diagnostic performance compared with Conventional Pap Smear (CPS) for cervical cancer screening and to compare the sensitivity and specificity of the two cytology methods with gold standard cervical biopsy. Methods: This is a hospital based cross-sectional study conducted from April 2017 to April 2018 in 110 sample randomly selected at gynecology OPD in Paropakar Maternity and Women’s Hospital. Paired samples (CPS and LBC) were taken from the same patient. Abnormal epithelial lesion detected in LBC and CPS was sent for biopsy. Bethedsa reporting system was followed and data analyzed in terms of diagnostic accuracy. Results: LBC vs CPS for satisfactory report was 96.4% vs 91.8% while unsatisfactory was 3.6% vs 1.8% (p=0.02). The detection of premalignant lesions was ASCUS 2.7%, HSIL 4.5%, ASCUS-H 1.8% and LSIL 0.9% by LBC while by CPS- ASC-US 0.9%, HSIL 3.6%, LSIL 1.8% and ASC-H 0.9% were detected. The sensitivity and specificity of LBC vs CPS was 100% vs 88% and 81.8% vs 99% respectively. The positive predictive and negative predictive value of LBC vs CPS was 81.8% vs 88% and 100% vs 99% respectively. Conclusions: Cell pick-up was satisfactory in both LBC and CPS. The sensitivity and positive predictive value of CPS is similar whereas the positive predictive value of LBC is less than its sensitivity. Cervical cancer screening with CPS is effective alternative over LBC by its cost and level of accuracy.

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Assessing the implementation of population based cervical cancer screening in Amadora, Portugal

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1291 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Leite ◽

S Pereira ◽

D Vaz ◽

T Smet ◽

C Portilheiro ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Positive Predictive Value ◽

Cervical Cancer Screening ◽

Predictive Value ◽

Intraepithelial Neoplasia ◽

Cost Effective ◽

Target Population ◽

Population Based ◽

Screening Tests

Abstract Background Population-based cervical cancer screening (CCS) are deemed to be more cost-effective than opportunistic screening and to reduce inequalities. Implementation in Portugal has been heterogeneous, at the regional level. In Amadora healthcare cluster (Lisbon area), implementation started in April 2018 in a pilot unit and was scaled-up. We aimed to assess population-based CCS implementation in Amadora. Methods Population-based CCS targets women aged 30-65, and utilises liquid-based cytology with partial HPV genotyping (HPV16/18 and other high-risk HPV - hrHPV). Samples positive for other hrHPV undergo a cytology. HPV16/18+ and other hrHPV+ with ≥ASCUS (atypical squamous cells of undetermined significance) are referred to colposcopy. We assessed implementation according to key indicators extracted from our information system: geographic coverage, number of tests, positive results, positive predictive value of referral (number of cervical intraepithelial neoplasia-CIN/number colposcopies). Results As of 30 August 2019, CCS were in place in 4 of the 9 units, potentially covering 20904 women (48.4% of the target population). 1797 womem performed screening within the programme. Invitation for screening is currently implemented in 1 of the 4 units. Screening results were available for 1702 women, 11,1% were HPV+. From these, 26,5% were HPV 16/18+ and 86.2% positive for other hrHPV. Among the latter, 63.2% were negative for intraepithelial lesion and 36.8% were ≥ASCUS. Overall, of these 189 women, 51.3% (n = 97) were referred for colposcopy. Colposcopy results were available for 37 women, of which 13 had a CIN. PPV of referral was 35.1% (95%confidence interval: 20.7;52.6). Conclusions Despite being a population-based screening most tests are still opportunistic. There is still a limited number of colposcopies results but the current PPV of referral is low and requires further investigation. Implementation towards a full population-based screening in Amadora should continue. Key messages Implementation of a population-based cervical cancer screening in Amadora, Portugal is underway but most screening tests are still applied in an opportunistic manner. A limited number of results is avaliable to estimate positive predictive value of referral to colposcopy. Results available indicate a value of 35.1%, which requires further investigation.

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