PCR detection rates of high risk human papillomavirus DNA in paired self-collected urine and cervical scrapes after laser CO2 conization for high-grade cervical intraepithelial neoplasia

Fambrini, Massimiliano; Penna, Carlo; Pieralli, Annalisa; Bussani, Cecilia; Fallani, Maria Grazia; Andersson, Karin L.; Scarselli, Gianfranco; Marchionni, M

doi:10.1016/j.ygyno.2007.12.032

Cited by 18 publications

(19 citation statements)

References 34 publications

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“…3), where HPV incidence ranged from 0% to 18% at 2 to 6 months post-treatment and 0% to 24% at >6 to 35 months post-treatment. Among women treated with laser conization, HPV incidence appeared relatively lower: one study found no incident HPV infections at 3, 6, or 12 months post-treatment [26], and another found HPV incidences of 1% in pre-treatment HPV positive women and 7% in pre-treatment HPV negative women after a longer follow-up duration of 35 months [33]. Only one study used laser ablation, and found an incidence of 15% in all women and 0% in pre-treatment HPV positive women at 3 months [20].…”

Section: Resultsmentioning

confidence: 99%

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The incidence of human papillomavirus infection following treatment for cervical neoplasia: A systematic review

Rositch

Soeters

Offutt-Powell

et al. 2014

Gynecologic Oncology

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Objective To systematically review the published literature in order to estimate the incidence and describe the variability of human papillomavirus (HPV) infection in women following treatment for cervical neoplasia. Methods Several scientific literature databases (e.g. PubMed, ISI Web of Science) were searched through January 31, 2012. Eligible articles provided data on (i) baseline HPV infection status within 6 months prior to or at time of treatment (pre-treatment); and (ii) HPV test results for women's first visit after treatment occurring within 36 months (post-treatment). We abstracted and summarized the post-treatment incidence of newly detected HPV genotypes that were not present at pre-treatment, overall and stratified by study and other population characteristics. Results A total of 25 studies were included, reporting post-treatment HPV incidence in nearly 2000 women. Mean patient age ranged from 31 to 43 years (median 36). Most studies used cervical exfoliated cell specimens to test for HPV DNA (n = 20; 80%), using polymerase chain reaction (n = 21; 84%). Cervical neoplasia treatment included loop electrical excision procedure (n = 11; 44%); laser conization (n = 2; 8%); laser ablation, surgical conization, cryotherapy, alpha-interferon (n = 1; 4% each); or multiple treatment regimens (n = 8; 32%). Follow-up times post-treatment ranged from 1.5 to 36 months (median 6). More than half of studies (n = 17; 68%) estimated the incidence of any HPV type following treatment, while 7 (28%) focused specifically on high-risk (HR) HPV. HPV incidence after treatment varied widely, ranging from 0 to 47% (interquartile range: 0%-15%) in up to 3 years of follow-up after treatment. Lower HPV incidence was observed among studies that included relatively younger women, used laser conization, focused on HR-HPV rather than overall HPV infection, and had a lower proportion of recurrent cervical disease. Conclusions These modest summary incidence estimates from the published literature can guide clinicians, epidemiologists and health economists in developing best practices for post-treatment cervical cancer prevention.

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Section: Resultsmentioning

confidence: 99%

“…However, clinically relevant trends were consistently observed within large studies, including an increase in HPV incidence over follow-up time [17,22]. Patterns were also observed across studies, such as the low incidence of HPV in women treated by laser conization [26,33] relative to other treatment modalities.…”

Section: Discussionmentioning

confidence: 98%

The incidence of human papillomavirus infection following treatment for cervical neoplasia: A systematic review

Rositch

Soeters

Offutt-Powell

et al. 2014

Gynecologic Oncology

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“…Several studies in small and large clinical and field settings have evaluated urine-based sampling for carcinogenic HPV detection in comparison with cervical or other external genital sampling (7,9,10,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), but their study designs have been heterogeneous and outcomes have been somewhat inconsistent. It has been observed that sampling approach, storage conditions, sample preparation, DNA extraction, and DNA amplification affect HPV DNA detection.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Human Papillomavirus Detections in Urine, Vulvar, and Cervical Samples from Women Attending a Colposcopy Clinic

et al. 2014

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e While urine-based sampling for human papillomavirus (HPV) is being explored as a simple and noninvasive approach for cervical cancer screening, data comparing HPV genotyping in urine and those in cellular sampling of the cervix and vulva, and their correlation with rigorously confirmed cervical disease status, are sparse. We performed HPV genotyping on voided-urine and clinician-collected vulvar and cervical samples from 72 women undergoing colposcopy. Although urine-based HPV carcinogenic HPV detection was lower (58.3%) than cervical (73.6%) and vulvar (72.1%) detection (P ‫؍‬ 0.05 and 0.07, respectively), the agreement of urine HPV with cervical and vulvar HPV was moderate (kappa ‫؍‬ 0.55) and substantial (kappa ‫؍‬ 0.62), respectively. Urine-based carcinogenic HPV detection had a clinical sensitivity of 80.8% (95% confidence interval [CI] ‫؍‬ 60.7 to 93.5) and a specificity of 53.3% (95% CI ‫؍‬ 37.9 to 68.3) for diagnosing cervical intraepithelial neoplasia grades 2/3 (CIN2/3) on histology; 90.0% of CIN3 was positive for urine HPV. The corresponding sensitivity and specificity values for vulvar sampling were 92% (95% CI ‫؍‬ 74 to 99) and 40.5% (95% CI ‫؍‬ 25.6 to 56.7), and those for cervical sampling were 96.2% (95% CI ‫؍‬ 80.4 to 99.9) and 40% (95% CI ‫؍‬ 25.7 to 55.7), respectively. HPV16 was the most common carcinogenic genotype detectable in 25% of urine, 33.8% of vulvar, and 31.9% of cervical samples overall, with prevalence increasing with cervical disease grade, regardless of the sampling method. Stronger cervical HPV PCR signal strengths were associated with increased frequency of urine HPV detection. In summary, the relatively lower detection rates but comparable clinical performance of urine-based HPV sampling underscore the need for larger studies to evaluate urine-based sampling for cervical cancer screening, epidemiologic studies, and postvaccination HPV disease surveillance. Human papillomavirus (HPV)-based primary screening or cotesting is being increasingly implemented as an alternative to cytology-based screening (1). Unlike cytology, HPV testing is amenable to simplified approaches for sample collection, including self-collected vaginal samples and urine-based sampling. These approaches may offer alternatives to clinic-based screening and improve access to care, particularly for hard-to-reach populations (2-11). While urine-based screening offers simplicity in sample collection, there are few studies of clinical performance of urine-based sampling and HPV genotypes detectable by this approach compared to that of cervical and external genital sampling in relation to rigorously confirmed cervical disease status. To expand the evidence in this area, we conducted a pilot study in a colposcopy referral population to evaluate HPV detection in voided urine samples, compare it to clinician-collected external genital (vulvar) and cervical sampling, and correlate results against histologically confirmed cervical disease ascertainment. MATERIALS AND METHODSThe study was nested within the National Ca...

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“…Furthermore, urine samples have been successfully used in the post-treatment follow-up of cervical cancer. 18 An essential part of any trial is the endpoint related sampling. The sample should be of good quality, stable until processing, reproducible, feasible and user-friendly for the participants of the trial.…”

Section: The Use Of Urine In the Follow-up Of Hpv Vaccine Trialsmentioning

confidence: 99%

The use of urine in the follow-up of HPV vaccine trials

Vorsters¹,

Keer²,

Damme³

2015

Human Vaccines & Immunotherapeutics

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PCR detection rates of high risk human papillomavirus DNA in paired self-collected urine and cervical scrapes after laser CO2 conization for high-grade cervical intraepithelial neoplasia

Cited by 18 publications

References 34 publications

The incidence of human papillomavirus infection following treatment for cervical neoplasia: A systematic review

The incidence of human papillomavirus infection following treatment for cervical neoplasia: A systematic review

Comparison of Human Papillomavirus Detections in Urine, Vulvar, and Cervical Samples from Women Attending a Colposcopy Clinic

The use of urine in the follow-up of HPV vaccine trials

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