A population-based study of human papillomavirus deoxyribonucleic acid testing for predicting cervical intraepithelial neoplasia

Kjellberg, Lennart; Wiklund, Fredrik; Sjöberg, Inga; Wadell, Göran; Ángström, T; Dillner, Joakim; Mählck, Carl-Gustav

doi:10.1016/s0002-9378(98)70015-8

Cited by 23 publications

(10 citation statements)

References 22 publications

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“…For example, a population-based study of HPV DNA presence in the Swedish screening program indicated that HPV DNA testing might be useful in triaging particularly among women age Ͼ 40 years. 28 The British reader participating in our study was much more like his American counterparts, although he tended to classify more tests as SIL. If representative of British readers as a whole, this finding would suggest that studies of HPV triage of equivocal cytology in the U.S. and the U.K. might have broadly similar implications for clinical practice in both countries.…”

Section: Discussionmentioning

confidence: 78%

Use of human papillomavirus DNA testing to compare equivocal cervical cytologic interpretations in the United States, Scandinavia, and the United Kingdom

Scott

Hagmar²,

Maddox³

et al. 2002

Cancer

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Section: Discussionmentioning

confidence: 78%

Use of human papillomavirus DNA testing to compare equivocal cervical cytologic interpretations in the United States, Scandinavia, and the United Kingdom

Scott

Hagmar²,

Maddox³

et al. 2002

Cancer

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“…HPV PCR analysis, HPV typing and antibody analysis were carried out as described previously (Kjellberg et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

“…Although the sample for HPV DNA detection was taken identically for all cases and controls, the fact that the 114 cases sampled in 1993-1994 had had their previous Pap smear taken with a different utensil might have introduced differential misclassification bias. This was investigated by comparing the HPV results for cases sampled before and after January 1995, and no differences were found (Kjellberg et al, 1998).…”

Section: Sampling Proceduresmentioning

confidence: 99%

Smoking, diet, pregnancy and oral contraceptive use as risk factors for cervical intra-epithelial neoplasia in relation to human papillomavirus infection

et al. 2000

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Smoking, nutrition, parity and oral contraceptive use have been reported as major environmental risk factors for cervical cancer. After the discovery of the very strong link between human papillomavirus (HPV) infection and cervical cancer, it is unclear whether the association of these environmental factors with cervical cancer reflect secondary associations attributable to confounding by HPV, if they are independent risk factors or whether they may act as cofactors to HPV infection in cervical carcinogenesis. To investigate this issue, we performed a population-based case–control study in the Västerbotten county of Northern Sweden of 137 women with high-grade cervical intra-epithelial neoplasia (CIN 2–3) and 253 healthy age-matched women. The women answered a 94-item questionnaire on diet, smoking, oral contraceptive use and sexual history and donated specimens for diagnosis of present HPV infection (nested polymerase chain reaction on cervical brush samples) and for past or present HPV infections (HPV seropositivity). The previously described protective effects of dietary micronutrients were not detected. Pregnancy appeared to be a risk factor in the multivariate analysis ( P < 0.0001). Prolonged oral contraceptive use and sexual history were associated with CIN 2–3 in univariate analysis, but these associations lost significance after taking HPV into account. Smoking was associated with CIN 2–3 (odds ratio (OR) 2.6, 95% confidence interval (CI) 1.7–4.0), the effect was dose-dependent ( P = 0.002) and the smoking-associated risk was not affected by adjusting for HPV, neither when adjusting for HPV DNA (OR 2.5, CI 1.3–4.9) nor when adjusting for HPV seropositivity (OR 3.0, CI 1.9–4.7). In conclusion, after taking HPV into account, smoking appeared to be the most significant environmental risk factor for cervical neoplasia. © 2000 Cancer Research Campaign

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“…The clearest role for HPV testing at the moment is in the management of women with borderline or mildly dyskaryotic smears (Kjellberg et al, 1998;Manos et al, 1999;Nobbenhuis et al, 1999;Solomon et al, submitted 3. HPV testing appears to be less specific than cytology (as used for referral in the UK screening programme) with false-positive rates ranging from 3-10% in 'normal' women aged over 35 years: false-positive rates are higher in younger women.…”

Section: Conclusion Implications and Recommendationsmentioning

confidence: 99%

A systematic review of the role of human papilloma virus (HPV) testing within a cervical screening programme: summary and conclusions

Cuzick¹,

Sasieni²,

Davies

et al. 2000

Br J Cancer

135

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A systematic review of the available evidence on the role of HPV testing in cervical screening has been published by the Health Technology Assessment Committee of the UK Department of Health. The review summarized relevant data on testing methods, natural history, and prevalence of the virus in different disease groups. Cost-effectiveness modelling was undertaken. Ten major conclusions were reached and are reported here. The key conclusions were that HPV testing was more sensitive than cytology, but that there were concerns about specificity, especially in young women. The increased sensitivity led to a recommendation that HPV testing be introduced on a pilot basis for women with borderline and mild smears. HPV testing has great potential as a primary screening test, but large trials are needed to properly evaluate this application and to determine if its introduction can reduce invasive cancer rates. There is an urgent need to undertake a large trial of HPV testing in conjunction with other new technologies (liquid-based cytology and computer-assisted cytology reading) to determine the best way to integrate them into ongoing screening programmes. A range of issues including the age to start and stop screening, the appropriate screening interval, the role of self-sampling for HPV testing and the choice of primary test (HPV and/or cytology) require further evaluation. © 2000 Cancer Research Campaign

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A population-based study of human papillomavirus deoxyribonucleic acid testing for predicting cervical intraepithelial neoplasia

Cited by 23 publications

References 22 publications

Use of human papillomavirus DNA testing to compare equivocal cervical cytologic interpretations in the United States, Scandinavia, and the United Kingdom

Use of human papillomavirus DNA testing to compare equivocal cervical cytologic interpretations in the United States, Scandinavia, and the United Kingdom

Smoking, diet, pregnancy and oral contraceptive use as risk factors for cervical intra-epithelial neoplasia in relation to human papillomavirus infection

A systematic review of the role of human papilloma virus (HPV) testing within a cervical screening programme: summary and conclusions

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