Searching for an ideal cervical cancer screening model to reduce false-negative errors in a country with high prevalence of cervical cancer

Song, Taejong; Seong, Seok Ju; Lee, Seon Kyung; Kim, Byoung Ryun; Ju, Woong; Kim, Ki Hyung; Nam, Kae Hyun; Sim, Jongsung; Kim, Tae Jin

doi:10.1080/01443615.2019.1621813

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…In the retrospective study In another study, Song et al (22) showed that when Pap test and HPV tests were used together, they achieved excellent performance in detecting CIN or cervical cancer, and the combined use of the tests significantly reduced false negative errors.…”

Section: Discussionmentioning

confidence: 99%

HPV DNA pozitif olguların servikal smear ile korelasyon sonuçları her zaman uyumlu mudur?

Zergeroğlu

Özkan

AYDIN

2023

Journal of Medicine and Palliative Care

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Aim: Cervical cancer is a type of genital cancer which come second after breast cancer in women and may cause death. However, it can be prevented with screening tests by ensuring early diagnosis. Most of cervical cancers (99.7%) are associated with Human Papilloma Virus (HPV) and it is known that HPV must be present for the generation of cervical cancer. Thus, 70% of the patients have been found to be positive for HPV-16 and HPV-18. Both the association with cervical cancer and HPV and data related to development of cancer and dysplasia was researched retrospectively in this study. It was aimed to analyze and use the results by examine if the smear results of the patients and the HPV results are compatible in all HPV positive cases. Material and Method: 1050 patients who were examined by gynecologist and taken Pap smear test at the end of the examination during July 2020 and March 2022, were included in our study. In all cases the Pap test was re-evaluated by the same pathologist using the 2014 Bethesda System. High-risk HPV (HR HPV) DNA (HPV types 16,18,31,33,35,39,45,51,52,56,58,59,66,68) tests results, applied to the patients at an external center, were reviewed. Results of patients diagnosed as LSIL, HSIL and cervical cancer by Pap smear test were evaluated again beside HPV DNA analyses and their clinical information. Chi-square test was used for statistical analysis. p

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Section: Discussionmentioning

confidence: 99%

HPV DNA pozitif olguların servikal smear ile korelasyon sonuçları her zaman uyumlu mudur?

Zergeroğlu

Özkan

AYDIN

2023

Journal of Medicine and Palliative Care

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“…21 , 22 , 23 Furthermore, it is sometimes difficult to distinguish metaplastic epithelial cells from atypical epithelial cells in a cytological examination. 24 , 25 , 26 Second, cervical lesions are representative of a continuous disease spectrum rather than discrete states. Categorizing this continuous spectrum into discrete systems (i.e., CIN classification and the two‐tier classification) can underestimate the extent of variation in the disease spectrum (i.e., loss of information), which may result in diagnostic misclassification.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic precision of histological examination has been shown to depend on the quality of specimen processing 21–23 . Furthermore, it is sometimes difficult to distinguish metaplastic epithelial cells from atypical epithelial cells in a cytological examination 24–26 . Second, cervical lesions are representative of a continuous disease spectrum rather than discrete states.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of high‐risk human papillomavirus‐related cervical lesions: A hidden Markov model analysis of a single‐center cohort in Japan

et al. 2021

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Introduction Previous studies have shown that individuals with human papillomavirus (HPV)‐related cervical lesions have different prognoses according to the HPV genotype. However, these studies failed to account for possible diagnostic misclassification. In this retrospective cohort study, we aimed to clarify the natural course of cervical lesions according to HPV genotype to account for any diagnostic misclassification. Materials and Methods Our cohort included 729 patients classified as having cervical intraepithelial neoplasia (CIN). HPV was genotyped in all patients, who were followed up or treated for cervical lesions at the University of Tokyo Hospital from October 1, 2008 to March 31, 2015. Hidden Markov models were applied to estimate the diagnostic misclassification probabilities of the current diagnostic practice (histology and cytology) and the transitions between true states. We then simulated two‐year transition probabilities between true cervical states according to HPV genotype. Results Compared with lesions in patients with other HPV genotypes, lesions in HPV 16‐positive patients were estimated to be more likely to increase in severity (i.e., CIN3/cancer); over 2 years, 17.7% (95% confidence interval [CI], 9.3%–29.3%) and 27.8% (95% CI, 16.6%–43.5%) of those with HPV 16 progressed to CIN3/cancer from the true states of CIN1 and CIN2, respectively, whereas 55%–70% of CIN1/2 patients infected with HPV 52/58 remained in the CIN1/2 category. Misclassification was estimated to occur at a rate of 3%–38% in the current diagnostic practice. Conclusion This study contributes robust evidence to current literature on cervical lesion prognosis according to HPV genotype and quantifies the diagnostic misclassification of true cervical lesions.

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“…Although the incidence of cervical cancer has decreased due to screening through cytologic tests, screening based solely on this method is considered to be inefficient because of low sensitivity and frequency of testing. 14 Previous clinical trials have demonstrated co-test of HPV genotypes with cytology had a greater sensitivity for screening of cervical cancer and precancerous lesions as compared to cytologybased screening. 15 These tests also have a greater sensitivity in detecting glandular precancerous lesions or adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Comparative performance of various human papillomavirus assays available in Korea for detecting cervical intraepithelial neoplasia

Ouh

Park

Kang

et al. 2021

J of Obstet and Gynaecol

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Aim:The aim of this study was to evaluate the clinical performance for detecting cervical intraepithelial neoplasia (CIN) 2 or higher lesions among available human papillomavirus infection (HPV) genotyping tests in Korea. Methods: Eligible patients visited 13 tertiary hospitals for colposcopic biopsy following cervical cytology and HPV genotyping test between January and December 2018. Baseline characteristics including age, body mass index (BMI), and parity were collected from 3798 patients. The performance of the Roche Cobas HPV 4800 was evaluated against other domestic HPV assays to detect CIN2 or higher. Results: A total of seven types of HPV genotyping tests were analyzed in the research institutes. A total of 1358 patients (35.8%) tested Anyplex II HPV 28 and 701 patients (18.5%) tested Cobas 4800 HPV. The overall sensitivity in the detection of CIN2 or higher was 41.5% (38.9-44.1) in patients positive for HPV 16/18. The Cobas test for HPV 16/18 was concordant with other assays evaluated for detection of CIN2 or higher and showed sensitivity of 46.6%, which was not significantly different from other assays. Although Anyplex II HPV28 (Seegene) showed slightly decreased sensitivity for detecting CIN2 or higher lesion with HPV

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Searching for an ideal cervical cancer screening model to reduce false-negative errors in a country with high prevalence of cervical cancer

Cited by 9 publications

References 19 publications

HPV DNA pozitif olguların servikal smear ile korelasyon sonuçları her zaman uyumlu mudur?

HPV DNA pozitif olguların servikal smear ile korelasyon sonuçları her zaman uyumlu mudur?

Prognosis of high‐risk human papillomavirus‐related cervical lesions: A hidden Markov model analysis of a single‐center cohort in Japan

Comparative performance of various human papillomavirus assays available in Korea for detecting cervical intraepithelial neoplasia

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