Cytology versus HPV testing for cervical cancer screening in the general population

Koliopoulos, George; Nyaga, Victoria Nyawira; Santesso, Nancy; Bryant, Andrew; Martin-Hirsch, P; Mustafa, Reem A.; Schünemann, Holger J.; Paraskevaidis, Evangelos; Arbyn, Marc

doi:10.1002/14651858.cd008587.pub2

Cited by 275 publications

(288 citation statements)

References 133 publications

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“…However, cytology is being replaced with HPV testing in several countries on the premise that HPV screening confers a higher sensitivity toward detection of lesions in women 30 years or older (≥30 years of age). [8][9][10] Moreover, the negative predictive value of HPV DNA testing is superior to that of cytology, 9 thereby allowing fewer screening rounds per women lifetime at equal or better safety than cytology. The evidence for HPV screening 9 was mainly established using nondiscriminatory HPV assays reporting only hrHPV-positive or hrHPV-negative outcomes without ability to differentiate between genotype(s) of an infection.…”

Section: Introductionmentioning

confidence: 99%

Bayesian analysis of baseline risk of CIN2 and ≥CIN3 by HPV genotype in a European referral cohort

Bonde

Bottari

Parvu

et al. 2019

Intl Journal of Cancer

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Whereas HPV16 and HPV18 have been the focus in current risk‐based cervical cancer screening algorithms using HPV genotype information, mounting evidence suggests that oncogenic HPV types such as HPV31, 33, 52 and 58 pose a ≥CIN3 risk equivalent to or greater than that of HPV18, and the combined risk of HPV31 and HPV33 rivals even HPV16 in women above 30 years of age. Here, we evaluate the baseline risk of CIN2 and CIN3 by genotype in a colposcopy referral population from Denmark and Italy. In total, 655 women were enrolled upon a referral to colposcopy after a positive screening sample. All samples were HPV analyzed using Onclarity HPV assay with extended genotyping and combined with the histology outcomes, a Bayesian probability modeling was used to determine the risk per genotype assessed. The combined data for this referral population showed that the ≥CIN2 risk of HPV16 was 69.1%, HPV31 at 63.3%, HPV33/58 at 52.7%, HPV18 at 46.6% and HPV52 at 40.8%. For ≥CIN3, the risks were 44.3%, 38.5%, 36.8%, 30.9% and 16.8% for HPV16, HPV31, HPV18, HPV33/58 and HPV52, respectively, indicating that the baseline risk of disease arising from HPV16 is, not surprisingly, the highest among the oncogenic HPV genotypes. We find that the HPV genotype‐specific ≥CIN2 and ≥CIN3 risk‐patterns are so distinct that, for example, 35/39/68 and 56/59/66 should be considered only for low intensive follow‐up, thereby proposing active use of this information in triage strategies for screening HPV‐positive women.

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Section: Introductionmentioning

confidence: 99%

Bayesian analysis of baseline risk of CIN2 and ≥CIN3 by HPV genotype in a European referral cohort

Bonde

Bottari

Parvu

et al. 2019

Intl Journal of Cancer

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“…Compared to the Pap test, HPV testing of samples obtained by a health care professional offers increased sensitivity, a slightly decreased specificity, and different rates of false positive and false negative test results (Koliopoulos et al, 2017). HPV testing can be conducted on self-collected samples with slightly decreased sensitivity and specificity compared to samples collected by a health care professional (Arbyn et al, 2014).…”

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confidence: 99%

“They Should Be Asking Us”: A Qualitative Decisional Needs Assessment for Women Considering Cervical Cancer Screening

Wood

Russell

El‐Khatib

et al. 2018

Global Qualitative Nursing Research

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In this study, we examine from multiple perspectives, women’s shared decision-making needs when considering cervical screening options: Pap testing, in-clinic human papillomavirus (HPV) testing, self-collected HPV testing, or no screening. The Ottawa Decision Support Framework guided the development of the interview schedule. We conducted semi-structured interviews with seven screen-eligible women and five health care professionals (three health care providers and two health system managers). Women did not perceive that cervical screening involves a “decision,” which limited their knowledge of options, risks, and benefits. Women and health professionals emphasized how a trusted primary care provider can support women making a choice among cervical screening modalities. Having all cervical screening options recommended and funded was perceived as an important step to facilitate shared decision making. Supporting women in making preference-based decisions in cervical cancer screening may increase screening among those who do not undergo screening regularly and decrease uptake in women who are over-screened.

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“…[27][28][29][30][31][32][33][34][35] Cervical cytology shows wider variation in sensitivity (34%-96%; median, 64%) than specificity (92%-98%; median, 96%) for predicting hHSILs. 36 Anal cytology studies largely describe screening outcomes alone, and few report complete HRA/histology data. Among those that do, the sensitivity and specificity for Dacron (anal) cytology to predict hHSILs varied widely: 19% 37 to 89% 38 and 40% [38][39][40] to 88%, 37 respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of nylon‐flocked swab and Dacron swab cytology for anal HSIL detection in transgender women and gay, bisexual, and other men who have sex with men

Wiley

Hsu

Ganser

et al. 2019

Cancer Cytopathology

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Background An anal histological high‐grade squamous intraepithelial lesion (hHSIL) is an anal cancer precursor. Experts recommend Dacron swab anal cytology as a primary screen for anal hHSILs, especially among human immunodeficiency virus–infected and –uninfected men who have sex with men (MSM). Studies have shown that Dacron cytology inaccurately predicts anal hHSILs and results in unnecessary diagnostic procedures. Nylon‐flocked (NF) swabs have been shown to trap pathogens and cells well. Thus, this study compared test characteristics of anal cytology using NF and Dacron swab collection protocols to predict anal hHSILs. Methods A single‐visit, randomized clinical trial compared NF and Dacron swab anal cytology specimens to predict high‐resolution anoscopy and biopsy–diagnosed anal hHSILs. Data for 326 gay men, bisexual men, other MSM, and male‐to‐female transgender women contributed descriptive and tabular statistics with which unadjusted and fully adjusted logistic regression models were constructed. The models estimated the odds of hHSILs, test accuracy (area under the curve [AUC]) and sensitivity, and specificity as well as the positive and negative predictive values of abnormal NF and Dacron cytology for predicting hHSILs. Results In the fully adjusted model, the sensitivities for NF and Dacron cytology were nearly equal (48% vs 47%), but the specificity was higher with NF cytology (76% vs 69%). Comparisons of the areas under receiver operating characteristic curves showed that NF cytology alone predicted hHSILs better than the covariate model (AUC, 0.69 vs 0.63; P = .02), but NF and Dacron cytology comparisons showed no statistically significant differences (AUC, 0.69 vs 0.67; P = .3). Conclusions NF cytology and Dacron cytology provide modest sensitivity, but NF cytology has higher specificity and accuracy, and this is important for lowering the costs of population‐based screening.

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Cytology versus HPV testing for cervical cancer screening in the general population

Abstract: versus HPV testing for cervical cancer screening in the general population.

Cited by 275 publications

References 133 publications

Bayesian analysis of baseline risk of CIN2 and ≥CIN3 by HPV genotype in a European referral cohort

Bayesian analysis of baseline risk of CIN2 and ≥CIN3 by HPV genotype in a European referral cohort

“They Should Be Asking Us”: A Qualitative Decisional Needs Assessment for Women Considering Cervical Cancer Screening

Comparison of nylon‐flocked swab and Dacron swab cytology for anal HSIL detection in transgender women and gay, bisexual, and other men who have sex with men

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