Proving the Causal Role of Human Papillomavirus in Cervical Cancer: A Tale of Multidisciplinary Science

Franco, Eduardo L.; Bosch, F. Xavier

doi:10.1016/b978-0-12-814457-2.00008-8

Cited by 5 publications

(4 citation statements)

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“…In fact, it should be more widely appreciated that it was the nearly universal adoption of such programs at the right time—in the 1960s and beyond—that prevented a cervical cancer epidemic that was to ensue consequently to the changes in sexual mores at that time, which led to increases in the transmission of genital human papillomavirus infection 2 . We did not know then that the latter is the causative agent of cervical cancer; that body of science only emerged in the 1980s 3 …”

Section: Figurementioning

confidence: 99%

“…2 We did not know then that the latter is the causative agent of cervical cancer; that body of science only emerged in the 1980s. 3 Most of my career has been focused on the science of cervical cancer prevention and control. When I was invited to attend a conference sponsored by Aristotle University in January of 2008 in Thessaloniki, Greece, I felt that the time had come to pay my personal tribute to the memory of the giant whose work I had been trying to improve in my own research.…”

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confidence: 99%

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Homage to Georgios Papanikolaou: A pilgrimage to his birthplace

Franco

2023

Cancer Cytopathology

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As a cancer epidemiologist focused on the science of cervical cancer prevention and control, the author journeyed to the home of his hero, Georgios Nikolaou Papanikolaou, whose pioneering contribution of the cervicovaginal cytology test (the Pap test) has saved countless female lives over generations throughout the world, laying the groundwork for one of the most beautiful stories in public health.

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Section: Figurementioning

confidence: 99%

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confidence: 99%

Homage to Georgios Papanikolaou: A pilgrimage to his birthplace

Franco

2023

Cancer Cytopathology

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“…Cervical cancer is caused by persistent infection with high risk Human Papillomavirus (HPV) types [9]. The HPV test, which detects high risk HPV DNA in cervical cells, has emerged as a significant improvement over cytology for cervical cancer screening.…”

Section: Introductionmentioning

confidence: 99%

Ensuring a successful transition from Pap to HPV-based primary screening in Canada: a study protocol to investigate the psychosocial correlates of women’s screening intentions

Griffin-Mathieu¹,

Haward²,

Tatar

et al. 2022

Preprint

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Introduction The Human Papillomavirus (HPV) test has emerged as a significant improvement over cytology for primary cervical cancer screening. In Canada, provinces and territories are moving towards implementing HPV testing in cervical cancer screening programs. While an abundance of research exists on the benefits of HPV-based screening, there is a dearth of research examining women′s understanding of HPV testing. In other countries, failure to adequately address women′s concerns about changes has disrupted implementation of HPV-based screening. This study protocol describes a multi-step approach to develop psychometrically valid measures and to investigate psychosocial correlates of women′s intentions to participate in HPV-based cervical cancer screening. Materials and Methods We conducted a web-based survey of Canadian women to assess the acceptability and feasibility of a questionnaire, including validation of scales examining: cervical cancer knowledge, HPV testing knowledge, HPV testing attitudes and beliefs, and HPV test self-sampling attitudes and beliefs. Preferences for cervical cancer screening were assessed using Best-Worst Scaling methodology. A second web-based survey will be administered to a national sample of Canadian women in June-July of 2022 using the validated scales. Differences in the knowledge, attitudes, beliefs, and preferences of women who are currently either underscreened or adequately screened for cervical cancer will be examined through bivariate analyses. Multinomial logistic regression will be used to estimate the associations between psychosocial and sociodemographic factors and intentions to screen using HPV-based screening. Study Impact and Dissemination Findings will provide direction for Canadian public health authorities to align guidelines to address women′s concerns and optimize acceptability and uptake of HPV-based primary screening. Validated scales can be used by other researchers to improve and standardize measurement of psychosocial factors impacting HPV test acceptability. Study results will be disseminated through peer-reviewed journal articles, conference presentations, and direct communication with researchers, clinicians, policymakers, media, and specialty organizations.

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“…C ervical cytology has an undisputable long history of success as a cancer screening tool. 1 Although effective, its well-documented limitations (i.e., low sensitivity, poor reproducibility, and costly infrastructure) 2 and the mounting literature on the clinical superiority of molecular human papillomavirus (HPV) DNA testing to morphological cytology [3][4][5][6] favor HPV primary screening for the prevention and early detection of cervical precancers. Despite practical concerns regarding the age range for screening, screening intervals, and management of high-risk HPV-positive women-so as to avoid excessive colposcopy and harmful overtreatment-many countries, including the Netherlands, Italy, Finland, Sweden, Mexico, and Turkey have already introduced HPV primary screening.…”

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confidence: 99%

Genotyping and Cytology Triage of High-Risk HPV DNA Positive Women for Detection of Cervical High-Grade Lesions

El‐Zein

Bouten

Abdrabo

et al. 2022

J Low Genit Tract Dis

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ObjectiveA demonstration project of primary human papillomavirus (HPV) testing was initiated in 2011 among more than 23,000 women attending routine cervical cancer screening. We examined the additional diagnostic performance of HPV genotyping for detecting disease in women with abnormal cytology.MethodsWomen aged 30 to 65 years were originally screened for HPV using Hybrid Capture II test. Women with positive results were triaged using conventional cytology, and those with atypical squamous cells of undetermined significance or worse (≥ASC-US) were referred to colposcopy. We retrospectively genotyped (Roche cobas 4800 HPV system [Roche Molecular Systems Inc, Pleasanton, CA]) cervical specimens that were HPV+ with Hybrid Capture II test and extracted women's medical history postbaseline screening. We calculated positive predictive values (PPVs) and 95% confidence intervals (CIs) of triage tests to detect histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) within the first year of follow-up among women positive for HPV16, HPV18, and HPV16 and/or HPV18 as well as among those negative for HPVs 16 and 18.ResultsOf 1,396 HPV-positive women, 1,092 (78%) were classified as normal, 136 (10%) had CIN1, 80 (6%) had CIN2, 81 (6%) had CIN3, and 7 women had cancer throughout the entire follow-up period. Seventy CIN2+ cases were detected within the first year of follow-up. The PPV for detecting CIN2+ was 20.9% (63/239; 95% CI = 16.4–25.9) for ASC-US+ cytology. In women with ASC-US+, PPVs were 31.2% (24/77; 95% CI = 21.1–42.7) for HPV16+, 27.8% (5/18; 95% CI = 9.7–53.5) for HPV18+, 30.8% (28/91; 95% CI = 21.5–41.3) for HPV16+ and/or HPV18+ women, and 16.6% (35/211; 95% CI = 11.8–22.3) in women testing negative for HPVs 16 and 18.ConclusionPartial genotyping as an additional triage strategy to cytology can markedly improve clinical diagnostic performance.

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Proving the Causal Role of Human Papillomavirus in Cervical Cancer: A Tale of Multidisciplinary Science

Cited by 5 publications

References 50 publications

Homage to Georgios Papanikolaou: A pilgrimage to his birthplace

Homage to Georgios Papanikolaou: A pilgrimage to his birthplace

Ensuring a successful transition from Pap to HPV-based primary screening in Canada: a study protocol to investigate the psychosocial correlates of women’s screening intentions

Genotyping and Cytology Triage of High-Risk HPV DNA Positive Women for Detection of Cervical High-Grade Lesions

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