Screening with a primary human papillomavirus test does not increase detection of cervical cancer and intraepithelial neoplasia 3

Kotaniemi-Talonen, Laura; Anttila, Ahti; Malila, Nea; Tarkkanen, Jussi; Laurila, Pekka; Hakama, Matti; Nieminen, Pekka

doi:10.1016/j.ejca.2007.12.002

Cited by 42 publications

(31 citation statements)

References 24 publications

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“…Nevertheless, we have just reported our 2-year results of enrolment which suggest that HPV DNA test does not increase detection of cervical cancer and CIN 3. 19 By contrast, follow-up studies have shown that due to increased sensitivity, HPV DNA test detects CIN 3 earlier. 26,27 To evaluate the role of gained sensitivity in HPV DNA detection, additional studies are needed emphasis especially on women at different ages.…”

Section: Discussionmentioning

confidence: 99%

“…Further details for the randomisation and screening protocols are published elsewhere. 6,19,20 Running of the trial within the Finnish cervical screening programme was accepted by the principal authorities in medicoethical issues in Finland, the National Authority for Medicolegal Affairs, the ethical committee of local hospital district, and health boards of the committed municipalities.…”

Section: Study Populationmentioning

confidence: 99%

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Prevalence of oncogenic human papillomavirus infection in an organised screening population in Finland

Leinonen

Kotaniemi-Talonen

Anttila

et al. 2008

Intl Journal of Cancer

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A persistent high-risk human papillomavirus (hrHPV) infection is a necessary condition for developing a cervical intraepithelial neoplasia and cervical cancer. The viral aetiology in cervical carcinogenesis has stimulated attempts to use HPV DNA detection in cervical cancer screening. In Finland there is an ongoing study assessing the benefits of primary HPV DNA testing in the setting of centrally organised mass screening for cervical cancer. Here we present the age-specific prevalence of hrHPV infection and associated sociodemographic factors of 16,895 women aged 25-65 years attending the 5-yearly cervical cancer screening between years 2003 and 2004. The overall hrHPV prevalence rate was 7.5%. The peak prevalence at the age group of 25-29 was 24.1% decreasing steadily thereafter to approximately 2.9% in women aged 65 years. Young age and marital status were the main determinants for oncogenic HPV types. Our study confirms the inverse relationship between age and hrHPV prevalence reported in many developed countries. As our prevalence rates and hence background risk for cervical cancer are not lower than in other European countries, it is likely that our lowest cervical cancer burden in Europe is due to health care actions justifying the organised cervical cancer screening. ' 2008 Wiley-Liss, Inc.Key words: high-risk HPV; prevalence; age; cervical cancer; screeningIn Finland an organised nationwide screening programme has been running over 40 years, reducing the age-adjusted incidence and mortality of cervical cancer by 80%, 1 incidence rate being about 4 cases per 100,000 woman-years nowadays. Nevertheless, there are still about 160 new cancer cases every year making the cervical cancer the third most common gynaecological cancer, but 20th of all female cancers, in Finland. 2 However, during the last 10 years, the cervical cancer incidence rate has been increasing among young target ages of the screening programme which is mainly due to inadequate attendance rates to the screening programme. 1 Cohort effects related to changes in exposure to risk factors such as sexual behaviour and smoking habits may also partly explain the increase.Despite the enormous impacts of cytology based screening on cervical cancer incidence and mortality rates in Finland, the Pap test has its limitations as errors in sample taking and in interpretation. As it is known that a persistent high-risk human papillomavirus (hrHPV) infection is a necessary condition for developing a cervical intraepithelial neoplasia (CIN) and cervical cancer 3 and moreover, hrHPV DNA is found in virtually all cases of cervical cancer, 4,5 HPV DNA detection has been suggested for cervical cancer screening as the primary test.To find out whether using HPV DNA detection can bring increase into the routine population-based screening programme effectiveness in Finland, a commercial hrHPV detection test, Hybrid Capture 2 (HC 2, Digene Corporation, Gaithersburg, MD), has been implemented into cervical cancer screening programme as the primary screening test sinc...

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Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Prevalence of oncogenic human papillomavirus infection in an organised screening population in Finland

Leinonen

Kotaniemi-Talonen

Anttila

et al. 2008

Intl Journal of Cancer

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“…Pap smear test is the main screening method used for the secondary prevention of cervical cancer. It can detect precancerous cells easily (Kotaniemi-Talonen et al, 2008). The Pap smear testing is an effective method of detecting, preventing and delaying the progress of cervical cancer (Bebis et al, 2012;Sogukpinar et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Level of Awareness of Cervical and Breast Cancer Risk Factors and Safe Practices among College Teachers of Different States in India: Do Awareness Programmes Have an Impact on Adoption of Safe Practices?

Shankar¹,

Rath²,

Roy³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Breast and cervical cancers are the most common causes of cancer mortality among women in India, but actually they are largely preventable diseases. Although early detection is the only way to reduce morbidity and mortality, there are limited data on breast and cervical cancer knowledge, safe practices and attitudes of teachers in India. The purpose of this study is to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. Materials and Methods: This assessment was part of a pink chain campaign on cancer awareness. During cancer awareness events in 2011 at various women colleges in different parts in India, a pre-test related to cervical cancer and breast cancer was followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of the interactive session, at 6 months and 1 year. Results: A total of 156 out of 182 teachers participated in the study (overall response rate was 85.7 %). Mean age of the study population was 42.4 years (range-28-59 yrs). There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of breast self examination (BSE) was significantly more frequent in comparison to CBE, mammography and the Pap test. Magazines and newspapers were sources for knowledge regarding screening tests for breast cancer in more than 60% of teachers where as more than 75% were educated by doctors regarding the Pap test. Post awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons for not doing screening test were found to be ignorance (50%), lethargic attitude (44.8%) and lack of time (34.6%). Conclusions: Level of knowledge of breast cancer risk factors, symptoms and screening methods was high as compared to cervical cancer. There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of BSE was significantly greater in comparison to CBE, mammography and the Pap test. To inculcate safe practices in lifestyle of people, awareness programmes such as pink chain campaign should be conducted more widely and frequently.

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“…They also reported high-risk human papillomavirus (hrHPV) test positivity in 80% of these case smears, (25). An experimental screening design is ongoing in the Finnish program (26,27). A systematic cytology triage with careful independent evaluation phases within the cytology laboratory and in a panel can be recommended based on our experiences from the current study.…”

Section: Discussionmentioning

confidence: 99%

Low Proportion of False-Negative Smears in the Finnish Program for Cervical Cancer Screening

Lönnberg

Anttila

Kotaniemi-Talonen

et al. 2010

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: We assessed the performance and validity of cytology in the Finnish screening program by considering high-grade neoplasia and cervical cancer (CIN3+) rates as detected in the program and by reevaluating cases observed after a negative screening test.Methods: This retrospective study included 915 screen-detected CIN3+ cases and 421 cases observed after a negative screen. Randomized and blinded reevaluation of potential false-negative screening tests covered 345 archival case smears from women without a referral to colposcopy, as well as 689 control smears for estimating performance and validity measures.Results: The false-negative rate at the cutoff of low-grade squamous intraepithelial lesion or worse was 35% (95% confidence interval, 30-40%). In the subpopulation with original screening result of Pap I, the false-negative rate was 23% (18-28%). Sensitivity of screening laboratory rereading for detecting low-grade lesions or worse as atypical was 75% (67-82%) and specificity 93% (91-94%). Reproducibility of specific cytologic diagnoses was only fair. False negatives constituted 11% of all CIN3+ diagnoses in the screened population; those false negatives with an original Pap I screening result constituted 5%.Conclusions: Although screen failures in the form of diagnostic false negatives occur within the Finnish screening program, their effect on cancer incidence is fairly small and cannot be readily decreased without sacrificing the high specificity of screening or without high incremental costs. Feedback for the screening laboratories is needed, however, to improve the reproducibility of cytologic diagnoses to optimize the burden of intensified follow-up and treatment of precancerous lesions. Cancer Epidemiol Biomarkers Prev; 19(2); 381-7. ©2010

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Screening with a primary human papillomavirus test does not increase detection of cervical cancer and intraepithelial neoplasia 3

Cited by 42 publications

References 24 publications

Prevalence of oncogenic human papillomavirus infection in an organised screening population in Finland

Prevalence of oncogenic human papillomavirus infection in an organised screening population in Finland

Level of Awareness of Cervical and Breast Cancer Risk Factors and Safe Practices among College Teachers of Different States in India: Do Awareness Programmes Have an Impact on Adoption of Safe Practices?

Low Proportion of False-Negative Smears in the Finnish Program for Cervical Cancer Screening

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