Use of a high-risk human papillomavirus DNA test as the primary test in a cervical cancer screening programme: a population-based cohort study.
BJOG
; 120(10): 1260-7; discussion 1267-8, 2013 Sep.
Article
em En
| MEDLINE
| ID: mdl-23786222
ABSTRACT
OBJECTIVE:
To present the results of the first 2 years of a human papillomavirus (HPV) test-based screening programme outside the research context.DESIGN:
Population-based cohort study.SETTING:
A cervical service screening programme in Italy. POPULATION Women aged 25-64 years invited to screening from April 2009 to April 2011.METHODS:
Eligible women were invited to undergo an HPV test those with a negative HPV test went on to the next screening episode; those with a positive HPV went on to triage with a Pap smear. Women with positive cytology (i.e. positive for atypical squamous cells of undetermined significance or worse, ASC-US+) were referred to colposcopy, whereas those with negative cytology were referred to repeat HPV testing 1 year later. MAIN OUTCOMEMEASURES:
Participation rate, positivity at HPV and at triage, referral rate to colposcopy, positive predictive value for cervical intraepithelial neoplasia grade 2+ (CIN2+) at colposcopy, and detection rate for CIN2+.RESULTS:
Participation increased compared with the previous Pap programme (60.6 versus 43.9%). The HPV positivity rate was 7.0; 39.6% of Pap smears were scored as positive, and therefore 2.8% of the women screened were referred for immediate colposcopy. The compliance of women who scored positive for HPV and negative for Pap for repeat HPV testing at 12 months was 78.6%, and the HPV positivity rate was 56.6%. The overall referral rate to colposcopy was 4.6%. The overall detection rate for CIN2+ was 4.5 versus 1.5% of the Pap programme (25-34 years, 8.2%; 35+ years, 3.6%).CONCLUSIONS:
Compared with the traditional Pap test, the HPV programme recorded a higher response to invitation and an increased DR for CIN2+. The most critical aspects were the reading of cytology in women that were positive for HPV and the increased workload at colposcopy.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Papillomaviridae
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DNA Viral
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Displasia do Colo do Útero
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Neoplasias do Colo do Útero
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Colo do Útero
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Infecções por Papillomavirus
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Detecção Precoce de Câncer
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Adult
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Female
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Humans
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Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article