Cost effectiveness analysis of HPV primary screening and dual stain cytology triage compared with cervical cytology

Termrungruanglert, Wichai; Khemapech, Nipon; Tantitamit, Tanitra; Havanond, Piyalamporn

doi:10.3802/jgo.2019.30.e17

Cited by 21 publications

(21 citation statements)

References 32 publications

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“…Women positive for HPV 16 and 18 will be directly referred for colposcopy, while those positive for other oncogenic types will be advised to undergo cytology triage and will be referred for colposcopy only if the cytology is abnormal, with a threshold of ASCUS. Another alternative strategy, p16/Ki-67 dual staining, for triage of HPV-positive women has been shown to have higher specificity and be more cost-effective in Thailand, compared with cytology [40].…”

Section: Koreamentioning

confidence: 99%

National screening programs for cervical cancer in Asian countries

Saitoh

Yin

et al. 2020

J Gynecol Oncol

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Cervical cancer is still one of the most common female cancers in Asia and the leading cause of cancer-related deaths in low-and middle-income countries. Nowadays, national screening programs for cervical cancer are widely provided in Asian countries. We reviewed the National Cancer Screening Program (NCSP) in China, India, Indonesia, Japan, Korea, and Thailand. The NCSP were established at varying times, from 1962 in Japan to 2014 in Indonesia. The primary screening method is based on cytology in all countries except for India and Indonesia. In India and Indonesia, visual inspection of the cervix with acetic acid (VIA) is mainly used as a primary screening method, and a "see and treat" strategy is applied to women with a positive VIA result. The starting age of NCSP ranges from 18 years in China to 30 years in Thailand. The screening interval is 2 years in all countries except for China and Indonesia, in which it is 3 years. Uptake rates of NCSP vary from 5.0%-59.7%. Many women in low-and middle-income countries still do not participate in NCSP. To improve uptake rates and thereby prevent more cases of cervical cancer, Asian countries should continue to promote NCSP to the public using various approaches.

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Section: Koreamentioning

confidence: 99%

National screening programs for cervical cancer in Asian countries

Saitoh

Yin

et al. 2020

J Gynecol Oncol

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“…Removing redundant features can greatly reduce the time for SVM to find the optimal solution while ensuring accuracy. Therefore, this paper uses the LASSO algorithm [22] to perform the embedded selection of features, as shown in equation (7). The results are shown in Table 1.…”

Section: B Feature Selection and Fusionmentioning

confidence: 99%

“…Among them, the DNA ploidy analysis and detection technology analyzes changes in the number and total number of chromosomes in the cell's DNA to determine whether cervical cells have changed due to disease. HPV quantitative detection has a high specificity, and it is easy to have a low missed diagnosis rate when screening advanced lesions [7]. (6) The HPV-TCT combined detection method is a commonly used method, with high sensitivity, a low false negative rate, a low false positive rate, etc.…”

Section: Introductionmentioning

confidence: 99%

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Classification of Cervical Biopsy Images Based on LASSO and EL-SVM

Huang

Zhang

et al. 2020

IEEE Access

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Cervical biopsy (biopsy) is an important part of the diagnosis of cervical cancer. The artificial classification of biopsy images in diagnosis is difficult and depends on the clinical experience of pathologists. However, the classification accuracy of computerized biopsy tissue images with similar lesions is low, and the problem of incomplete experimental objects needs to be addressed. This paper proposes a method of cervical biopsy tissue image classification based on least absolute shrinkage and selection operator (LASSO) and ensemble learning-support vector machine (EL-SVM). Using the LASSO algorithm for feature selection, the average optimization time was reduced by 35.87 seconds while ensuring the accuracy of the classification, and then serial fusion was performed. The EL-SVM classifier was used to identify and classify 468 biopsy tissue images, and the receiver operating characteristic (ROC) curve and error curve were used to evaluate the generalization ability of the classifier. Experiments show that the normalcervical cancer classification accuracy reached 99.64%, the normal-low-grade squamous intraepithelial lesion (LSIL) classification accuracy was 84.25%, the normal-high-grade squamous intraepithelial lesion (HSIL) classification accuracy was 87.40%, the LSIL-HSIL classification accuracy was 76.34%, the LSILcervical cancer classification accuracy was 91.88%, and the HSIL-cervical cancer classification accuracy was 81.54%.

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“…Recent advances in digital imaging and machine learning show promise to also automate the slide evaluation [73]. Although dual stain cytology is unsuitable for self-collected samples [74], it is worthwhile to evaluate the test as part of novel screening algorithms also in LMICS [75][76][77].…”

Section: Evaluation Of Screening Technologiesmentioning

confidence: 99%

Novel concepts in cervical cancer screening: a comparison of VIA, HPV DNA test and p16INK4a/Ki-67 dual stain cytology in Western Kenya

Orang’o

Were

Rode

et al. 2020

Infect Agents Cancer

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Background Screening of unvaccinated women remains essential to mitigate the high morbidity/mortality of cervical cancer. Here, we compared visual inspection with acetic acid (VIA), recommended by WHO as the most cost-effective screening approach in LMICs, with HPV-based screening, and usage of p16INK4a/Ki-67 dual stain cytology. Methods We prospectively enrolled women participating in a VIA-based cervical cancer screening program in two peri-urban health centers of Kenya. Consenting women had a VIA examination preceded by collection of a liquid-based cytology sample from the cervix stored in PreservCyt medium (Hologic®). Analysis of all samples included a hrHPV DNA test and evaluation of a p16INK4a /Ki-67 (CINtecPLUS®) dual stained slide that was prepared using the ThinPrep® 2000 Processor and evaluated by a pathologist trained in the methodology. Results In 701 of a total of 800 women aged 18–64 years, all three investigations were performed and data could be analyzed. The HPV, VIA and dual stain cytology positivity were 33%, 7%, and 2% respectively. The HPV positivity rate of VIA positive cases was 32%. The five most common HPV types were HPV16, 52, 68, 58 and 35. The OR among HIV infected women of an HPV infection, VIA positivity and positive dual stain cytology were 2.6 (95%CI 1.5–4.3), 1.9 (95%CI 0.89–4.4) and 3.4 (95%CI 1.07–10.9) respectively. The sensitivity of VIA to detect a p16INK4a/Ki-67 positive transforming infection was 13% (95%CI 2–38). Conclusions Primary HPV testing appears feasible and should be considered as a primary screening test also in LMICs. The poor sensitivity of VIA renders it unsuitable as a triage test for HPV positive women. The utility of p16INK4a/Ki-67 dual stain cytology as a triage test for HPV positive women in LMICs should be further studied.

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Cost effectiveness analysis of HPV primary screening and dual stain cytology triage compared with cervical cytology

Cited by 21 publications

References 32 publications

National screening programs for cervical cancer in Asian countries

National screening programs for cervical cancer in Asian countries

Classification of Cervical Biopsy Images Based on LASSO and EL-SVM

Novel concepts in cervical cancer screening: a comparison of VIA, HPV DNA test and p16INK4a/Ki-67 dual stain cytology in Western Kenya

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