Long-term protection of HPV test in women at risk of cervical cancer

Abstract

Objective To evaluate the 9-year incidence of cervical intraepithelial neoplasia grade 2 or worse (CIN2 +) and cumulative adherence to perform a next test in a cohort of women aged 40+ years with no cervical screening cytology within a window of 5 years (underscreened women), after baseline cervical cytology and HPV tests. Methods In Catalonia, Spain, co-testing with cytology and HPV test has been recommended in the Public Health system since 2006 for underscreened women. In 2007, 1,594 women with underscreened criteria were identified and followed through medical records form Pathological Department. 9-year cumulative incidence of histologically confirmed CIN2+ and cumulative adherence to perform a next test were estimated using Kaplan-Meier statistics. Results Follow-up was available for 1,009 women (63.3%) resulting in 23 women with. CIN2+ (2.3%). Of them, 4 women (17%) had both tests negative at baseline (3CIN2 and 1CIN3) with cumulative incidence of CIN2+ of 0.4% (95% CI: 0.1-1.4) at 5-years and 1.3% (95% CI: 0.4-3.7) at 9-years. During the first year, the prevalence among women with both tests positive was 27.0% (95% CI: 13.0-50.6) for CIN2+. Lost to follow-up was higher among women

Cervical Cancer Prophylaxis—State-of-the-Art and Perspectives

“…Therefore, HPV tests should be considered to be of high value in protecting against the occurrence of CC for up to 10 years. The current consensus based on the availability of screening suggests repeated negative HPV tests at intervals of every 5 years [ 56 , 57 ]. Based on the Swedish experience, the costs associated with a diagnosis based on HPV testing (n = 16,544) and cervical cytology (n = 13,799) were compared.…”

“…The most common type is HPV 16 (50% of cases). Other oncogenic HPV types responsible for persistent cervical tissue infections include HPV 18,31,33,35,39,45,51,52,56,58,59, 66, and 68. However, infection alone is not sufficient for disease development.…”

Cervical cancer prevention: Human papillomavirus testing as primary screening

“…As such, reminder mechanisms should be in place to ensure women are rescreened regularly after an initial negative screen and followed up especially for those women not enrolled in routine care. In particular, WLHIV are more likely to become infected with HPV, 6 but they may underestimate their risk for HPV acquisition after a negative result and be less inclined to return for rescreening 40 . However, because HPV infections are more likely to advance to high‐grade cervical lesions and cervical cancer more quickly in HIV‐positive women, it is imperative that WLHIV are screened at consistent intervals to detect cases in a timely manner.…”

Clinical Validation of the Vitro HPV Screening Assay for Its Use in Primary Cervical Cancer Screening

“…All samples had been collected in ThinPrep medium and previously evaluated with the cobas ® 4800 HPV Test, which is the routine screening test. According to the screening protocol of this area [29], only HPV-positive samples had a cytological study performed and HPV-negative women would have another HPV test after five years. In cases with positive cytology (atypical squamous cervical cells of undetermined significance (ASC-US) or worse), the patient was referred to colposcopy and a biopsy was taken in case of abnormality.…”