The first-round results of a population-based cohort study of HPV testing in Japanese cervical cancer screening: baseline characteristics, screening results, and referral rate

Background: China’s Fujian Cervical Pilot Project (FCPP) transitioned cervical cancer screening from high-risk human papillomavirus (HR-HPV) nongenotyping to genotyping. We investigated the clinical impact of this introduction, comparing performance indicators between HR-HPV genotyping combined with cytology screening (HR-HPV genotyping period) and the previous HR-HPV nongenotyping combined with cytology screening (HR-HPV nongenotyping period). Methods: A retrospective population-based cohort study was performed using data from the FCPP for China. We obtained data for the HR-HPV nongenotyping period from 1 January 2012 to 31 December 2013, and for the HR-HPV genotyping period from 1 January 2014 to 31 December 2016. Propensity score matching was used to match women from the two periods. Multivariable Cox regression was used to assess factors associated with cervical intraepithelial neoplasia of grade 2 or worse (CIN2+). The primary outcome was the incidence of CIN2+ in women aged ⩾25 years. Performance was assessed and included consistency, reach, effectiveness, adoption, implementation and cost. Results: Compared with HR-HPV nongenotyping period, in the HR-HPV genotyping period, more CIN2+ cases were identified at the initial screening (3.06% versus 2.32%; p < 0.001); the rate of colposcopy referral was higher (10.87% versus 6.64%; p < 0.001); and the hazard ratio of CIN2+ diagnosis was 1.64 (95% confidence interval, 1.43–1.88; p < 0.001) after controlling for health insurance status and age. The total costs of the first round of screening (US$66,609 versus US$65,226; p = 0.293) were similar during the two periods. Higher screening coverage (25.95% versus 25.19%; p = 0.007), higher compliance with age recommendations (92.70% versus 91.69%; p = 0.001), lower over-screening (4.92% versus 10.15%; p < 0.001), and reduced unqualified samples (cytology: 1.48% versus 1.73%, p = 0.099; HR-HPV: 0.57% versus 1.34%, p < 0.001) were observed in the HR-HPV genotyping period. Conclusions: Introduction of an HR-HPV genotyping assay in China could detect more CIN2+ lesions at earlier stages and improve programmatic indicators. Evidence suggests that the introduction of HR-HPV genotyping is likely to accelerate the elimination of cervical cancer in China.

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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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Psychiatric morbidity and cervical cancer screening: a retrospective population-based case–cohort study

CMAJ Open ◽

10.9778/cmajo.20190184 ◽

2020 ◽

Vol 8 (1) ◽

pp. E134-E141

Author(s):

Michael Ouk ◽

Jodi D. Edwards ◽

Jessica Colby-Milley ◽

Alexander Kiss ◽

Walter Swardfager ◽

...

Keyword(s):

Cervical Cancer ◽

Cohort Study ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Psychiatric Morbidity ◽

Population Based

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Prospective cohort study examining cervical cancer screening methods in HIV-positive and HIV-negative Cambodian Women: a comparison of human papilloma virus testing, visualization with acetic acid and digital colposcopy

BMJ Open ◽

10.1136/bmjopen-2018-026887 ◽

2019 ◽

Vol 9 (2) ◽

pp. e026887 ◽

Cited By ~ 5

Author(s):

Sovannara Thay ◽

Andrew Goldstein ◽

Lena Sophia Goldstein ◽

Vaishnavi Govind ◽

Kruy Lim ◽

...

Keyword(s):

Cervical Cancer ◽

Acetic Acid ◽

Cohort Study ◽

Cancer Screening ◽

Human Papilloma Virus ◽

Cervical Cancer Screening ◽

Screening Methods ◽

Hpv Testing ◽

Papilloma Virus ◽

Hiv Women

ObjectivesLogistical and economic issues make traditional cytology-based cervical cancer screening challenging in developing countries. Alternative, cost-effective, screening strategies must be developed to screen millions of women in resource-poor countries such as Cambodia.DesignA prospective cohort study during which all women underwent four cervical cancer screening methods: (1) self-sampled human papilloma virus (HPV) testing (careHPV system), (2) clinician-collected HPV testing, (3) visualization with acetic acid (VIA) and (4) digital colposcopy (DC) with the Enhanced Visual Assessment System (EVA).SettingA referral hospital in Phnom Penh, Cambodia.ParticipantsTwo hundred and fifty Cambodian women (129 HIV+, 121 HIV-). Subjects were recruited from the National Center for HIV/AIDS Dermatology and sexually transmitted disease (STD) cohort, the Sihanouk Hospital Center of Hope’s Rural Outreach Teams and the Pochentong Medical Center.ResultsFifty six of the 250 (22.4%) patients tested positive for high-risk HPV (hrHPV+). Thirty seven of the 129 HIV+ women were hrHPV+ (28.6%) whereas 19/121 HIV- women were hrHPV+ (15.7%) p=0.0154. Self-sampling HPV specimens identified 50/56 (89%) whereas physician-collected specimens identified 45/56 (80%) p=0.174. 95.2% of the patients felt comfortable obtaining HPV self-samples. Thirty seven of 250 women were VIA+. Thirty of 37 VIA+ women underwent confirmatory biopsies for cervical intraepithelial neoplasia (CIN) (26 CIN1, 4 CIN2+). The rate of confirmed dysplasia in the HIV+ group was 20/129 (15.5%) compared with 10/121 (8.26%) in HIV- women p=0.0291. The contemporaneous physician impressions of the DC images accurately differentiated between CIN1 and CIN2+ lesions in all 30 women having confirmatory biopsies.ConclusionsThe results of this study suggest potential modifications of the current cervical screening strategy that is currently being employed in Cambodia. The first step in this new strategy would be self-swabbing for hrHPV. Subsequently, hrHPV+ patients would have DC and immediate treatment based on colposcopic findings: cryotherapy for suspected CIN1 and loop electrosurgical excision procedure (LEEP) for suspected CIN2+.

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Cervical cancer screening uptake among HIV-positive women in Ontario, Canada: A population-based retrospective cohort study

Preventive Medicine ◽

10.1016/j.ypmed.2017.11.023 ◽

2018 ◽

Vol 107 ◽

pp. 14-20 ◽

Cited By ~ 1

Author(s):

Ann N. Burchell ◽

Claire E. Kendall ◽

Stephanie Y. Cheng ◽

Aisha Lofters ◽

Michelle Cotterchio ◽

...

Keyword(s):

Cervical Cancer ◽

Cohort Study ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Population Based ◽

Hiv Positive ◽

Screening Uptake ◽

Hiv Positive Women

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Organization of cervical cancer screening with DNA–HPV testing impact on early–stage cancer detection: a population–based demonstration study in a Brazilian city

The Lancet Regional Health - Americas ◽

10.1016/j.lana.2021.100084 ◽

2021 ◽

pp. 100084

Author(s):

Julio Cesar Teixeira ◽

Diama Bhadra Vale ◽

Cirbia Silva Campos ◽

Joana Froes Bragança ◽

Michelle Garcia Discacciati ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Cancer Detection ◽

Early Stage ◽

Population Based ◽

Hpv Testing ◽

Early Stage Cancer

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Methodologies of Primary HPV Testing Currently Applied for Cervical Cancer Screening

Life ◽

10.3390/life10110290 ◽

2020 ◽

Vol 10 (11) ◽

pp. 290

Author(s):

Andreas C. Chrysostomou ◽

Leondios G. Kostrikis

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Pap Test ◽

Population Based ◽

World Health ◽

Hpv Testing ◽

Screening Programs ◽

European Guidelines ◽

Health Organization

The human papillomavirus is one of the most common sexually transmitted viruses, and an infection from this virus may become persistent, leading to diseases such as cervical cancer. In the past, cytology-based methods such as the Papanicolaou (Pap) test were imperative to identify the disease at a stage where it can be treated. However, since the 1980s where the etiological association of HPV and cervical cancer was identified, new tests began emerging directed towards identifying the virus. Furthermore, as the biology of HPV along with the relationships with its host are elucidated, these tests and treatments further advance. Recently in Europe, there is a movement towards the implementation of HPV testing methodologies in national screening programs to precede cytological testing. These screening strategies are recommended by the European guidelines and the World Health Organization. This review presents the current HPV testing methodologies, their application in organized population-based cervical cancer screening programs based on the most recent European guidelines, and their implementation status in countries in Europe.

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