Cervical Screening Test Results Associated With 265 Histopathologic Diagnoses of Cervical Glandular Neoplasia

Background: Malaysia continues to have a high incidence of cervical cancer with a relatively high mortality rate due to late presentation. Pilot Project R.O.S.E was a cross-sectional study to assess acceptability, feasibility and reach of a cervical screening strategy that utilizes self-collected, point-of-care HPV testing in primary care settings. Within this study, mobile SMS technology was used to register patients into a cervical screening registry and to deliver the HPV test results. Aim: To assess the feasibility, acceptability, advantages and limitations of the use of mobile SMS technology to deliver HPV screening test results. Methods: Invitation for cervical screening was offered to women aged 30 to 65 years who are presenting to these clinics for care, or accompanying another individual. Upon agreeing to do the test, the nurse registered the woman's details and mobile number. A mobile phone verification SMS is triggered at this point. HPV results were delivered to women via mobile SMS within 3 working days. Phone-based surveys were conducted on randomly selected screened positives and screened negative women to ascertain acceptability of the screening and the usage of mobile technology. Results: Ninety percent of participants received their SMS results without any hitches. Ten percent of participants experienced problems with receiving their results SMS. Further investigations revealed that there were various reasons for message delivery failure. Posttest surveys revealed that majority of participants were satisfied with the use of mobile technology to receive HPV screening test results. Conclusion: This study suggests that the use of mobile SMS technology for delivery of HPV screening test results is feasible and acceptable. However, measures should be taken to overcome technology related failures. The findings of this implementation research may help to inform the design of future mobile SMS technology usage within health settings in Malaysia.

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Follow-up Outcomes in a Large Cohort of Patients With Human Papillomavirus–Negative ASC-H Cervical Screening Test Results

Yearbook of Pathology and Laboratory Medicine ◽

10.1016/j.ypat.2012.11.005 ◽

2013 ◽

Vol 2013 ◽

pp. 276-277

Author(s):

S.S. Raab

Keyword(s):

Human Papillomavirus ◽

Screening Test ◽

Cervical Screening ◽

Large Cohort ◽

Test Results

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Follow-up Outcomes in a Large Cohort of Patients With HPV-Negative LSIL Cervical Screening Test Results

American Journal of Clinical Pathology ◽

10.1309/ajcpu57uelkuzcyy ◽

2015 ◽

Vol 143 (4) ◽

pp. 485-491 ◽

Cited By ~ 4

Author(s):

Stacey Barron ◽

R. Marshall Austin ◽

Zaibo Li ◽

Chengquan Zhao

Keyword(s):

Screening Test ◽

Cervical Screening ◽

Large Cohort ◽

Test Results

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Cytology and Human Papillomavirus Screening Test Results Associated With 2827 Histopathologic Diagnoses of Cervical Intraepithelial Neoplasia 2/3

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2012-0307-oa ◽

2012 ◽

Vol 137 (7) ◽

pp. 942-947 ◽

Cited By ~ 6

Author(s):

Chengquan Zhao ◽

Milon Amin ◽

Baoying Weng ◽

Xiangbai Chen ◽

Amal Kanbour-Shakir ◽

...

Keyword(s):

Human Papillomavirus ◽

Cervical Intraepithelial Neoplasia ◽

Screening Test ◽

Cervical Screening ◽

Intraepithelial Neoplasia ◽

High Grade ◽

Test Results ◽

Squamous Intraepithelial Lesion ◽

Squamous Cells ◽

Intraepithelial Lesion

Context.—Cervical screening in the United States increasingly involves newer US Food and Drug Administration–approved cytologic methods and adjunctive high-risk human papillomavirus (hrHPV) DNA testing. Objective.—To document cervical screening test performance preceding histopathologic cervical intraepithelial neoplasia (CIN) 2/3 diagnoses. Design.—Preceding screening test results with computer-imaged, liquid-based cytology (LBC) and hrHPV results were analyzed for 2827 patients with histopathologic CIN 2/3 diagnoses. Results.—Of 2827 patients with CIN 2/3 diagnoses, 2074 (73.4%) had system LBC findings within 4 months of CIN 2/3 diagnoses: high-grade squamous intraepithelial lesion (n = 862; 41.6%), low-grade squamous intraepithelial lesion (n = 464; 22.4%), atypical squamous cells of undetermined significance (n = 445; 21.5%), atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (n = 288; 13.9%), and atypical glandular cells/adenocarcinoma in situ (n = 15; 0.7%). Of the 2827 patients, 1488 (52.6%) also had earlier system LBC results at more than 4 months to 3 years before CIN 2/3 diagnoses: one or more abnormal LBC results (n = 978; 65.7%), one or more negative LBC results (n = 911; 61.2%), both abnormal and negative LBC (n = 401; 26.9%). Of 807 patients with hrHPV cotest results within 4 months of CIN 2/3 diagnoses, 786 (97.4%) had hrHPV+ results. Of 454 patients who also had earlier hrHPV results at more than 4 months to 3 years before CIN 2/3 diagnoses: 377 (83.0%) had one or more hrHPV+ result, 110 (24.2%) had one or more hrHPV− result, and 33 (7.3%) had both positive and negative HPV results. Conclusion.—Patients with histopathologic CIN 2/3 had recent abnormal LBC results, most often, high-grade squamous intraepithelial lesions. Among cotested patients, 97.4% (786 of 807) tested hrHPV+. However, a significant number of patients tested during an extended period of several years had earlier negative Papanicolaou or negative HPV test results, suggesting the recent development of some CIN 2/3 lesions and supporting the value of cotesting for enhanced detection of other developing, small, inaccessible, or nondiagnostic precursor lesions.

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Human Papillomavirus (HPV) 16 and 18/45 Genotyping-Directed Follow-up of Women With Messenger RNA HPV-Positive, Cytology-Negative Cervical Screening Test Results

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz156 ◽

2019 ◽

Vol 153 (2) ◽

pp. 243-250 ◽

Cited By ~ 2

Author(s):

Min Han ◽

Juan Li ◽

Marshall Austin ◽

Kavita R Varma ◽

Huina Zhang ◽

...

Keyword(s):

Human Papillomavirus ◽

Screening Test ◽

Messenger Rna ◽

Cervical Screening ◽

Test Results ◽

Positive Cytology ◽

Hpv 16 ◽

Cervical Adenocarcinomas ◽

High Risk Hpv

Abstract Objectives In this study, we sought to correlate genotype test results for human papillomavirus (HPV) types 16, 18, and 45 with histopathologic follow-up diagnoses in patients with messenger RNA (mRNA) high-risk HPV-positive, cytology-negative results. Methods We identified 1,157 patients with mRNA HPV-positive, cytology-negative cervical screening test results between June 2015 and June 2018. Reflex HPV 16/18/45 genotype results were documented in 1,018 women aged 30 years or older, 318 of whom had follow-up within 18 months. Results Histopathologic findings of cervical intraepithelial neoplasia 2 or worse (CIN2+) were diagnosed in 14 of 122 (11.5%) patients positive for HPV 16/18/45 vs in seven of 196 (3.6%) HPV 16/18/45–negative patients. Three patients with high-risk HPV–positive, cytology-negative cervical screening test results were diagnosed with stage I cervical adenocarcinomas following early colposcopic referral and biopsy after HPV 16/18/45–positive genotype results. Conclusions Immediate reflex HPV 16/18/45 genotyping of mRNA HPV-positive, cytology-negative patients led to early colposcopic referral and histopathologic diagnoses of three difficult-to-detect, low-stage, cervical adenocarcinomas and significantly increased overall early detection of CIN2+ lesions.

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Follow-up Outcomes in a Large Cohort of Patients With Human Papillomavirus–Negative ASC-H Cervical Screening Test Results

American Journal of Clinical Pathology ◽

10.1309/ajcpyk60bzrnnahq ◽

2012 ◽

Vol 138 (4) ◽

pp. 517-523 ◽

Cited By ~ 14

Author(s):

David Cohen ◽

R. Marshall Austin ◽

Christopher Gilbert ◽

Richard Freij ◽

Chengquan Zhao

Keyword(s):

Human Papillomavirus ◽

Screening Test ◽

Cervical Screening ◽

Large Cohort ◽

Test Results

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Personalized Medicine and Cervical Screening: Development of Individualized Quantitative Risk Assessments for Cervical Adenocarcinoma and Adenocarcinoma in situ

Acta Cytologica ◽

10.1159/000511620 ◽

2020 ◽

pp. 1-7

Author(s):

Terri E. Jones ◽

Agnieszka Onisko ◽

R. Marshall Austin

Keyword(s):

Health System ◽

Bayesian Modeling ◽

Screening Test ◽

Cervical Screening ◽

Cumulative Risk ◽

Cervical Adenocarcinoma ◽

Adenocarcinoma In Situ ◽

Test Results ◽

Cervical Biopsy

Introduction: Cervical screening has decreased the incidence of cervical carcinoma around the world primarily by preventing cervical squamous carcinoma, with significantly less measurable protective benefits in prevention of cervical adenocarcinoma. In this study, we apply Bayesian modeling of cervical clinical, screening, and biopsy data from a large integrated health system to explore the feasibility of calculating personalized risk assessments on screened system patients for subsequent histopathologic diagnoses of invasive cervical adenocarcinoma (AdCa) or cervical adenocarcinoma in situ (AIS). Materials and Methods: Diagnoses of cervical AIS or AdCa rendered between 2005 and 2018 were identified in our large health system database with 1,053,713 cytology results, 354,843 high-risk (hr) human papillomavirus (HPV) test results, and 99,012 cervical histopathologic results. Using our continuously updated Bayesian cervical cancer screening model which includes clinical data, cervical screening results, and cervical biopsy results, we projected quantitative estimates of patients’ 5-year cumulative risk for cervical AIS or AdCa. Results: 161 patients were identified with AIS (ages 17–75, mean 37 years), and 99 patients had diagnoses of cervical AdCa (ages 26–91, mean 48 years). Quantitative Bayesian 5-year cumulative risk projections for diagnoses of cervical AdCa or AIS in patients with different cervical screening test and biopsy histories were determined. The highest patient risk projections for subsequent cervical AdCa and/or AIS histopathologic diagnoses were associated with prior cervical screening test results of HPV-positive atypical glandular cells. Prior squamous cytologic abnormalities were associated with lower risk estimates. Prior histopathologic diagnoses of squamous abnormalities also influenced quantitative risk. A prior histopathologic diagnosis of AIS was associated with a very low risk of subsequent AdCa, consistent with effective excisional treatment. AdCa risk was greatest in women aged 30–65 years with prior CIN3 biopsy results, whereas AIS risk was greatest in women <30. Conclusion: Prevention of cervical AdCa in screened patients remains a major challenge for cervical screening. Individualized risk projections for cervical glandular neoplasia reflecting patient age, prior cervical screening test results, and prior cervical biopsy history are feasible using Bayesian modeling of health system data.

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Is it enough for COVID-19 screening test? Limitation of swab test and general characteristics of mild symptom patients

Science Progress ◽

10.1177/00368504211026152 ◽

2021 ◽

Vol 104 (2) ◽

pp. 003685042110261

Author(s):

Sungwoo Choi ◽

Hyo Jeong Choi ◽

Ho Jung Kim

Keyword(s):

Screening Test ◽

Community Treatment ◽

Upper Respiratory Tract ◽

Test Results ◽

Rt Pcr ◽

Pcr Assay ◽

Positive Rate ◽

Upper Respiratory ◽

Polymerase Chain ◽

Discharge Criteria

The most common method for SARS-CoV-2 testing is throat or nasal swabbing by real-time reverse transcription polymerase chain reaction (RT-PCR) assay. In South Korea, drive-through swab test is used for screening system and community treatment centers (CTCs), which admit and treat confirmed COVID-19 patients with mild symptoms, are being used. This retrospective study was conducted on patients admitted to a CTC on March 6, 2020. A total of 313 patients were admitted. The nasal and throat swabs were collected from the upper respiratory tract, and a sputum test was performed to obtain lower respiratory samples. The positive rate of the first set of test, sputum test was higher than that of the swab test ( p = 0.011). In the second set of test, 1 week after the first ones, the rate of positive swab tests was relatively high ( p = 0.026). In the first set of test, 66 of 152 (43.4%) patients showed 24-h consecutive negative swab test results, when the sputum test results were considered together, that number fell to 29 patients (19.1%) ( p < 0.001). Also, in the second set of test, 63 of 164 (38.4%) patients met the discharge criteria only when the swab test was considered; that number fell to 30 (18.3%) when the sputum test results were also considered ( p < 0.001). Using the swab test alone is insufficient for screening test and discharge decision. Patients who may have positive result in the sputum test can be missed.

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