Human papillomavirus testing versus repeat cytology for triage of minor cytological cervical lesions

Arbyn, Marc; Roelens, Jolien; Simoens, Cindy; Buntinx, Frank; Paraskevaidis, Evangelos; Martin-Hirsch, P; Prendiville, Walter

doi:10.1002/14651858.cd008054.pub2

Cited by 107 publications

(174 citation statements)

References 354 publications

Supporting

Mentioning

154

Contrasting

Unclassified

Order By: Relevance

“…The authors suggest that HPV testing can be recommended to triage women with ASCUS because it has higher accuracy (significantly higher sensitivity and similar specificity) than repeat cytology. They also point out that, in triaging women with LSIL, an HPV test yields a significantly higher sensitivity, but a significantly lower specificity, compared to a repeat cytology [20]. In line with these observations, in our study, we did not find significant correlation (P < 0.05) between HPV (C) status detected by PCR amplification of HPV DNA and cytological LSIL/HSIL changes ( Table 2).…”

Section: Resultssupporting

confidence: 90%

“…That is why it has been recommended to adhere to current guidelines in this population [19]. The review study of Arbyn et al [20] compared the accuracy of HPV testing against that of repeat cytology for detection of underlying CIN of grade 2 or worse (CIN 2C) or grade 3 or worse (CIN 3C) in women with ASCUS or LSIL. The authors suggest that HPV testing can be recommended to triage women with ASCUS because it has higher accuracy (significantly higher sensitivity and similar specificity) than repeat cytology.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Correlation between abnormal cytological findings and human papillomavirus infection of the uterine cervix in Bulgarian women

Kovachev

Slavov

2016

Biotechnology & Biotechnological Equipment

View full text Add to dashboard Cite

The aim of this study was to analyse the correlation between cases of human papillomavirus (HPVC/¡) infection of the uterine cervix revealed through HPV typing and cytological results from Papanicolaou (Pap)-stained cervical smears. Cervical smears of 421 Bulgarian women attending routine gynaecological examinations during the three-year study period were stained by the Pap technique and classified by the Bethesda system. GenoFlow HPV Array Test Kit was used to analyse the HPV status in the collected cervical samples. The results showed that, of the 421 women, 177 (42%) were HPV(C) and 244 (58%) were HPV(¡); 334 (79.3%) Pap smears were with normal morphology and 87 (20.7%) had high/low grade squamous intraepithelial lesion (LSIL/HSIL) changes. Of the 87 women with LSIL/HSIL changes, 54% (47/87) were HPV(¡) and 46% (40/87) were HPV(C). There was no statistically significant correlation between the HPV(C) status and the cytological LSIL/HSIL findings (P > 0.05). Koilocytes were found in 30.4% (128/421) of the samples. Of the 128 women with koilocytosis, 59.4% (76/128) were HPV(¡) and 40.6% (52/128) were HPV(C). There was no significant correlation (P > 0.05) between the presence of koilocytes in cervical smears and HPV infection. Our results suggest that HPV infection is frequent even in women with negative Pap-smear results, and polymerase chain reaction seems to be the only reliable test to diagnose this infection. However, the results from this study cannot be considered to fully support the replacement of cytology and colposcopy examination in cervical cancer screening with HPV genotyping tests only.

show abstract

Section: Resultssupporting

confidence: 90%

Section: Resultsmentioning

confidence: 99%

Correlation between abnormal cytological findings and human papillomavirus infection of the uterine cervix in Bulgarian women

Kovachev

Slavov

2016

Biotechnology & Biotechnological Equipment

View full text Add to dashboard Cite

show abstract

“…For the reasons described above, these test characteristics for primary HPV testing are considered to be conservative assumptions. Observed sensitivity for women with dLSIL , Arbyn et al 2013 Observed specificity for women with dLSIL , Arbyn et al 2013 Extensive sensitivity analysis was performed using a range of screening test characteristics for each test. These involved use of 'best-case' and 'worst-case' relative test performances compared to conventional cytology, which were consistent with the 95% CIs of the summary estimates of relative performance from the international metaanalyses for manually-read LBC and for HPV testing, and consistent with the range of outcomes observed in image-read LBC studies.…”

Section: Hpv Testingmentioning

confidence: 99%

HPV vaccine impact in Australian women: ready for an HPV‐based screening program

Brotherton

Gertig

May

et al. 2016

Medical Journal of Australia

View full text Add to dashboard Cite

Enquiries about the content of the report should be directed to the above address.The Medical Services Advisory Committee (MSAC) is an independent committee which has been established to provide advice to the Minister for Health and Ageing on the strength of evidence available on new and existing medical technologies and procedures in terms of their safety, effectiveness and costeffectiveness. This advice will help to inform government decisions about which medical services should attract funding under Medicare. MSAC's advice does not necessarily reflect the views of all individuals who participated in the MSAC evaluation. Publication approval number: Template Version updated Nov 08Application 1276 NCSP Renewal: Modelled evaluation i Table 38 Summary of the effect of poor compliance with 5-yearly call-andrecall (high proportion of early re-screening, CR2) compared with the equivalent strategy under assumptions of better compliance with 5-yearly screening (low proportion of early re-screening, most women re-attending on time (CR1)) for primary HPV testing strategies . Table 71 Health and cost outcomes in strategies where women never return for more cervical screening after being completely discharged after a normal HPV exit test (compared to the equivalent strategy where some women continue to return after an exit test at rates as observed under current practice) and assuming screening ends at 69 instead of 64 years for both sets of scenarios -unvaccinated cohort .. Table 72 Health and cost outcomes in strategies where women never return for more cervical screening after being completely discharged after a normal HPV exit test (compared to the equivalent strategy where some women continue to return after an exit test at rates as observed under current practice) and assuming screening ends at 69 instead of 64 years for both sets of scenarios -cohort offered vaccination at age 12 . The relative trade-off between the percent increase in the mortality and the percent increase in the colposcopies compared to current practice of cervical screening using image-read LBC ( The Renewal aims to ensure the continuing success of the NCSP and that all Australian women, HPV vaccinated and unvaccinated, have access to a cervical screening program based on current evidence and best practice. The Renewal process will ensure the renewed program remains safe and continues to improve health outcomes of Australian women. Contents List of Tables List of FiguresThe objectives of the Renewal are to:1. Assess the evidence for screening tests and pathways, the screening interval, age range and commencement for both vaccinated and non-vaccinated women;2. Determine a cost-effective screening pathway and program model;3. Investigate options for improved national data collection systems and registry functions to enable policy, planning, service delivery and quality management; and 4. Assess the feasibility and acceptability of the renewed program for women.The first two objectives outlined above are being undertaken th...

show abstract

“…ID is the study identifier, DIS is the number of diseased, TP is the number of true positives, NonDis is the number of healthy and TN is the number of true negatives. Arbyn et al (2012) and Arbyn et al (2013) …”

Section: Model Comparison and Selectionmentioning

confidence: 99%

CopulaDTA: An R Package for Copula-Based Bivariate Beta-Binomial Models for Diagnostic Test Accuracy Studies in a Bayesian Framework

Nyaga¹,

Arbyn²,

Aerts³

2017

J. Stat. Soft.

Self Cite

View full text Add to dashboard Cite

The current statistical procedures implemented in statistical software packages for pooling of diagnostic test accuracy data include HSROC regression (Rutter and Gatsonis 2001) and the bivariate random-effects meta-analysis model (BRMA; Reitsma et al. 2005;Arends et al. 2008;Chu and Cole 2006;Riley et al. 2007b). However, these models do not report the overall mean but rather the mean for a central study with random-effect equal to zero and have difficulties estimating the correlation between sensitivity and specificity when the number of studies in the meta-analysis is small and/or when the between-study variance is relatively large (Riley et al. 2007a).This tutorial on advanced statistical methods for meta-analysis of diagnostic accuracy studies discusses and demonstrates Bayesian modeling using the R package CopulaDTA (Nyaga 2017) to fit different models to obtain the meta-analytic parameter estimates. The focus is on the joint modeling of sensitivity and specificity using a copula based bivariate beta distribution. Essentially, we extend the work of Nikoloulopoulos (2015) by: (i) presenting the Bayesian approach which offers the flexibility and ability to perform complex statistical modeling even with small data sets and (ii) including covariate information, and (iii) providing an easy to use code. The statistical methods are illustrated by re-analyzing data of two published meta-analyses.Modeling sensitivity and specificity using the bivariate beta distribution provides marginal as well as study-specific parameter estimates as opposed to using the bivariate normal distribution (e.g., in BRMA) which only yields study-specific parameter estimates. Moreover, copula based models offer greater flexibility in modeling different correlation structures in contrast to the normal distribution which allows for only one correlation structure.

show abstract

Human papillomavirus testing versus repeat cytology for triage of minor cytological cervical lesions

Abstract: Human papillomavirus testing versus repeat cytology for triage of minor cytological cervical lesions.

Cited by 107 publications

References 354 publications

Correlation between abnormal cytological findings and human papillomavirus infection of the uterine cervix in Bulgarian women

Correlation between abnormal cytological findings and human papillomavirus infection of the uterine cervix in Bulgarian women

HPV vaccine impact in Australian women: ready for an HPV‐based screening program

CopulaDTA: An R Package for Copula-Based Bivariate Beta-Binomial Models for Diagnostic Test Accuracy Studies in a Bayesian Framework

Contact Info

Product

Resources

About