Initial results of a population-based cervical cancer screening program using HPV testing in 1 million women

Gültekin, M.; Karaca, Mujdegul Zayifoglu; Küçükyıldız, İrem; Dundar, Selin; Boztaş, Güledal; Turan, Semra Hatice; Hacıkamiloglu, Ezgi; Murtuza, Kamil; Keskinkılıç, Bekir; Şencan, İrfan

doi:10.1016/j.ygyno.2018.04.267

Cited by 2 publications

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“…Cytology has been the sole cervical cancer screening tool in the Brazilian program since its introduction in the 1970s. While some countries in Latin America (7) and Europe (8) have introduced HPV testing in combination with or in replacement of cytology, Brazilian government guidelines, last issued in 2016 (9), continue to exclusively recommend the Pap test for cervical cancer screening. However, a critical analysis of the historical results achieved by the program identified several technical deficiencies that may produce false-negative results, leading experts to advocate HPV DNA as an attractive alternative for cervical cancer screening (10).…”

Section: Introductionmentioning

confidence: 99%

High-Risk HPV Testing in Primary Screening for Cervical Cancer in the Public Health System, São Paulo, Brazil

Levi

Martins

Longatto‐Filho

et al. 2019

Cancer Prevention Research

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Every year there are approximately 16,000 new cases of cervical cancer in Brazil. Novel screening technologies may reduce this number by expanding the population coverage but also by improving the detection rate of precursor lesions. We aimed to evaluate human papillomaviruses (HPV)-DNA testing in the context of routine cervical cancer screening in the public health system of the city of São Paulo, Brazil. Women participating in the primary screening program were invited to enroll. Liquid-based cytology samples were collected and cytology and Hr-HPV DNA testing were performed in parallel. Cytologists were blind to HPV results. Women older than 24 years with a positive high-risk HPV test and/or cytology class ! ASC-US were referred to colposcopy. From December 2014 to December 2016, 16,102 women joined the study. High-risk human papilloma-virus (HR HPV) DNA prevalence was 14.9%, whereas cytologic abnormalities were found in 7.2% of the women. Per protocol, 1,592 Hr-HPV þ women, in addition to 72 patients with cytologic classification > lowgrade squamous intraepithelial lesion (LSIL) were referred. A total of 80 cervical intraepithelial neoplasia (CIN2 þ) cases were diagnosed, 79 were Hr-HPV DNA þ and 18 had normal cytology. Hr-HPV DNA detected a significant number of patients with premalignant lesions missed by cytology and all 16 CIN3 þ cases were Hr-HPV DNA þ. HPV genotyping may be useful in the management of Hr-HPV þ women, reducing the burden of colposcopic referral for those harboring genotypes with a weaker association to CIN3 þ. Use of HPV-DNA testing was shown to be feasible and advantageous over current cytologic screening in the public health system.

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Section: Introductionmentioning

confidence: 99%

High-Risk HPV Testing in Primary Screening for Cervical Cancer in the Public Health System, São Paulo, Brazil

Levi

Martins

Longatto‐Filho

et al. 2019

Cancer Prevention Research

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“…Population-based cervical cancer screening program of Turkey, which is conducted by Family Health Centers (ASM) and Cancer Early Diagnosis, Screening and Training Centers (KETEM), aims to screen women between ages 30-65 with high-risk human papillomavirus (HPV) testing and reflex cervical cytology in the case of HPV positivity (7). The results of our national cervical cancer screening program showed that the percentage of unsatisfactory cervical smears in HPV positive women was 14.1% in the initial publication of one million cases (7). Recently, the results of four million women are reported with a 16.2% of unsatisfactory cervical smears in HPV positivity (8).…”

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confidence: 99%

“…All high-risk HPV positive women with abnormal cytology or woman who are HPV 16 and/or 18 positive are referred for colposcopy. The details of screening program and the infrastructure and quality control of the laboratory processes are described elsewhere (7).…”

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confidence: 99%

Analysis of colposcopic findings of high-risk HPV positive women with unsatisfactory cervical cytology

Yorgancı¹,

Erkan

Selçuk

et al. 2021

Jinekoloji-Obstetrik Ve Neonatoloji Tıp Dergisi

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Aim: We aimed to analyze the colposcopic directed biopsy results of women with unsatisfactory cervical cytology and high-risk human papilloma virus (HPV) positivity, who were referred to the Gynecologic Oncology outpatient clinic from Cancer Early Diagnosis and Screening Centers. Materials and Methods: In this retrospective study, women with high-risk HPV subtypes who applied to our clinic between March 2015 and October 2017 with an inadequate cervical cytology underwent colposcopy-directed biopsy. Patients were grouped according to HPV types. The results of endocervical curettage, cervical biopsy, and cervical conization were analyzed.Results: Forty-six patients with unsatisfactory cervical cytology and high-risk HPV were included in this study during the 30-month period. Twenty-five (54.3%) of the patients had "non-16 non-18" HPV subtypes, while 21 (45.7%) had HPV 16 and/or HPV 18. Cervical biopsy results revealed high-grade squamous intraepithelial lesion (H-SIL) in 5 (10.9%) patients, low-grade squamous intraepithelial lesion (L-SIL) in 17 (37%), "HPV effect" in 4 (8.7%) and normal histopathology in 20 (43.5%) patients. The endocervical curettage revealed three (6.5%) women with H-SIL and seven (15.2%) with L-SIL. Seven (15.2%) patients underwent conization due to H-SIL and there were three H-SIL with negative margins and four L-SIL in the final histopathology report. Conclusion:Performing colposcopy seems to be crucial for women with inadequate cervical cytology and high-risk HPV regardless of HPV subtypes as there is an increased risk of H-SIL in this patient population.

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Initial results of a population-based cervical cancer screening program using HPV testing in 1 million women

Cited by 2 publications

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High-Risk HPV Testing in Primary Screening for Cervical Cancer in the Public Health System, São Paulo, Brazil

High-Risk HPV Testing in Primary Screening for Cervical Cancer in the Public Health System, São Paulo, Brazil

Analysis of colposcopic findings of high-risk HPV positive women with unsatisfactory cervical cytology

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