Detection rates for abnormal cervical smears: what are we screening for?

Raffle, Angela E.; Alden, B.; Mackenzie, E. F. D.

doi:10.1016/s0140-6736(95)91036-0

Cited by 126 publications

(68 citation statements)

References 9 publications

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“…It may look too radical since only 1% of women with CIN I are estimated to progress to invasive cervical cancer (Holowaty et al, 1999). In addition, identifying women with abnormal cervical changes put such women under stress that they are at a risk of developing cervical cancer, when in fact majority of them never develop the disease (Raffle et al, 1995). The presence of telomerase activity in the whole range of cervical samples from mild dysplasia to stage IV cancers suggests that telomerase is activated early and play an essential role during cervical carcinogenesis.…”

Section: Discussionmentioning

confidence: 99%

Telomerase activity as an adjunct to high-risk human papillomavirus types 16 and 18 and cytology screening in cervical cancer

et al. 2006

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Telomerase is a ribonucleoprotein comprising an RNA template, the telomerase-associated protein and its catalytic subunit, human telomerase reverse transcriptase (hTERT). Telomerase activation is a critical step in cellular immortalisation and development of cancer. Enhanced telomerase activity has been demonstrated in cervical cancer. In the present study telomerase activity and hTERT mRNA expression were evaluated and correlated with the presence of human papillomavirus (HPV) infection and cytological changes in the cervical lesions. Telomerase activity was assayed by telomeric repeat amplification protocol, hTERT mRNA expression by reverse transcriptase polymerase chain reaction and presence of high risk HPV (HR-HPV) infection by polymerase chain reaction. Out of 154 cervical samples of different cytology, 90 (58.44%) were positive for HR-HPV types 16/18, while among 55 normal cervical scrapes, 10 (18.18%) were HPV DNA positive. All 59 invasive cancer samples showed a very high telomerase activity. Among dysplasia, seven (63.6%) mild dysplasia, 18 (100%) of moderate, 20 (100%) of severe dysplasia and 6 (100%) carcinoma in situ (CIS) samples were positive with mild to moderate to high to very high telomerase activity respectively. Seven (12.7%) samples of apparently normal cervical scrapes were weakly positive for telomerase activity. We observed a good correlation (Po0.001) between telomerase activity and HR-HPV 16/18 positivity with a sensitivity of 88.1% for HPV and 100% for telomerase activity. It is suggested that telomerase activity may be used as an adjunct to cytology and HPV DNA testing in triaging women with cervical lesions.

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Section: Discussionmentioning

confidence: 99%

Telomerase activity as an adjunct to high-risk human papillomavirus types 16 and 18 and cytology screening in cervical cancer

et al. 2006

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“…Nevertheless, for example, the suspected suboptimal performance of screening in the UK in the 1990s (Raffle et al, 1995;Anonymous, 1998) may have contributed to the high relative risks reported in that period (Sasieni et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

Low risk of cervical cancer during a long period after negative screening in the Netherlands

2003

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A condition for effective cervical cancer screening is a low incidence of cervical cancer after negative screening compared to that in the absence of screening. This relative risk was studied for the period 1994 -1997 in the Netherlands and compared with previous studies. All cases of invasive cervical cancer diagnosed from 1994 to 1997 in the Netherlands were related to woman-years at risk, stratified by age, number of preceding negative screenings and time since the preceding negative screening. These incidence rates were compared with that before screening started in the Netherlands. The relative risk increases from 0.13 in the first year after screening to 0.24 after more than 6 years after screening for women with one previous negative screening. These figures reduce to 0.06 and 0.18, respectively, for women with two or more previous screenings. However, these estimates are less favourable when account is taken of the likely decrease in risk for cervical cancer in the period studied. Our data show a low relative risk of cervical cancer for several years following the last negative Pap smear. However, the denominator of the relative risk, that is, the incidence without screening, may have been overestimated. This applies also to the IARC multicountry study, and may have caused too optimistic expectations about the effectiveness of cervical cancer screening.

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“…Various diagnostic programs are available for HPV identification in different countries such as by using the traditional detection based on the Papanicolaou smear discovered in 1943. However, false negatives (between 15-50% for cervical premalignant lesions and cervical cancer) and false positives (30%) should be considered during screening by using that cytological technique Cuzick et al, 2003).Cytology examinations have limitations with regards to specificity and low predictive value for high grade pathology (Shafi 1994;Raffle et al, 1995). Highly sensitive methods have been developed to detect HPV such as: polymerase chain reaction (PCR) method; and is considered the most sensitive HPV detection technique worldwide (Young et al, 1989).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Human Papillomavirus in Women from Saudi Arabia

Turki¹,

Sait²,

Anfinan³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Human papillomavirus (HPV) infection is the main causes of cervical cancer in women worldwide. The goal of the present study was to determine the prevalence and distribution of HPV genotypes in women from Saudi Arabia. Recently, several HPV detection methods have been developed, each with different sensitivities and specificities. Methods: In this study, total forty cervical samples were subjected to polymerase chain reaction and hybridization to BioFilmChip microarray assessment. Results: Human papillomavirus (HPV) infections were found in 43% of the specimens. The most prevalent genotypes were HPV 16 (30%) HPV 18 (8.0%) followed by type HPV 45, occurring at 5.0%. Conclusion: Our finding showed the HPV infection and prevalence is increasing at alarming rate in women of Saudi Arabia. There was no low risk infection detected in the tested samples. The BioFilmChip microarray detection system is highly accurate and suitable for detection of single and multiple infections, allowing rapid detection with less time-consumption and easier performance as compared with other methods.

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Detection rates for abnormal cervical smears: what are we screening for?

Cited by 126 publications

References 9 publications

Telomerase activity as an adjunct to high-risk human papillomavirus types 16 and 18 and cytology screening in cervical cancer

Telomerase activity as an adjunct to high-risk human papillomavirus types 16 and 18 and cytology screening in cervical cancer

Low risk of cervical cancer during a long period after negative screening in the Netherlands

Prevalence of Human Papillomavirus in Women from Saudi Arabia

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