The detection of HPV DNA, the size of tampon specimens and the menstrual cycle.

Fairley, Christopher K; Robinson, Priscilla; Chen, Shujun; Tabrizi, S N; Garland, Suzanne M.

doi:10.1136/sti.70.3.171

Cited by 12 publications

(13 citation statements)

References 12 publications

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“…In this analysis, the frequency of positive HC2 results varied little by date of LMP. In a study based on PCR testing of tampon specimens, HPV detection was also unrelated to quartiles of the menstrual cycle (Fairley et al, 1994). Two studies in which subjects were repeatedly tested using PCR based assays found null associations between HPV detection and LMP; however, these reports conflicted about whether recent intercourse was associated with positive test results (Wheeler et al, 1996;Harper et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…However, efforts to coordinate return visits to re-screen women with unsatisfactory cytology often fail (McGarahan and Smith-McCune, 2005), and presumably, deferring screening for women who present near the time of menses would present similar problems. Given this dilemma, it is important to determine whether the advantages of liquid-based cytology methods, such as increased cellular recovery and reduction of obscuring by blood (Bernstein et al, 2001), eliminate the association between the performance of cytology and LMP that has been demonstrated for smears.Similarly, the implementation of concurrent human papillomavirus (HPV) DNA and cytologic testing in some settings highlights the need to clarify inconsistencies in reported analyses assessing the performance of HPV testing in relation to LMP (Schneider et al, 1992;Fairley et al, 1994;Wheeler et al, 1996;Van Ham et al, 2002;Harper et al, 2003). Accordingly, we analyzed data for cytology and HPV DNA testing by LMP collected in the National Cancer Institute sponsored ASCUS LSIL Triage Study (ALTS).…”

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confidence: 99%

“…Similarly, the implementation of concurrent human papillomavirus (HPV) DNA and cytologic testing in some settings highlights the need to clarify inconsistencies in reported analyses assessing the performance of HPV testing in relation to LMP (Schneider et al, 1992;Fairley et al, 1994;Wheeler et al, 1996;Van Ham et al, 2002;Harper et al, 2003). Accordingly, we analyzed data for cytology and HPV DNA testing by LMP collected in the National Cancer Institute sponsored ASCUS LSIL Triage Study (ALTS).…”

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Performance of cytology and human papillomavirus testing in relation to the menstrual cycle

2006

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Cervical smears prepared around the time of menses have been linked to unsatisfactory specimens and false negative results; however, it is unclear whether liquid-based cytology is similarly affected and data relating date of last menstrual period (LMP) to human papillomavirus (HPV) DNA testing are conflicting. Accordingly, we evaluated liquid-based cytology and HPV test results using Hybrid Capture 2 and PCR by LMP (days 0 -10; 11 -21; 22 -28). We studied 5060 participants in ALTS, the Atypical Squamous Cells of Undetermined Significance (ASCUS) Low Grade Squamous Intraepithelial Lesion (LSIL) Triage Study. On average, women had 3.4 examinations (median 4, range 1 -5) during a 2-year period of observation permitting an examination of intra-individual variation in cytology and HPV by LMP. Although uncommon, unsatisfactory cytology specimens were most likely on days 0 -10. For satisfactory specimens, the frequency with which cytologic categories were reported varied by time since LMP, although differences were modest and did not affect the chance of abnormal cytology or its severity among women diagnosed with CIN2 þ . The frequency of positive HC2 tests did not vary with date of LMP. Among HPV infected women, independent of eventual diagnosis and the number of viral genotypes present, mid-cycle specimens yielded the highest frequency of LSIL cytologic interpretations and the highest HPV load; however, the magnitude of these effects were small. Intraindividual correlations of cytology or HPV by LMP were generally weak. We conclude that mid-cycle specimens yield slightly higher HPV DNA loads and slightly increased LSIL interpretations, but the clinical impact is marginal. Standardizing collection times would slightly improve interpretation of trends in HPV load. Finally, these data are consistent with the view that the biological properties of the HPV-infected cervix vary with the date of the LMP. Historically, clinicians have recognized that cytologic samples collected on days of active menstruation are typically bloody and often yield smears that are hypocellular, obscured, and lack endocervical cells (Vooijs et al, 1987). Furthermore, data demonstrating that unsatisfactory cytology specimens are associated with a higher than expected frequency of cervical intraepithelial neoplasia (CIN) and carcinoma (Ransdell et al, 1997;Nygard et al, 2004) in later follow-up, suggest that that these specimens may be linked to false negative results. However, efforts to coordinate return visits to re-screen women with unsatisfactory cytology often fail (McGarahan and Smith-McCune, 2005), and presumably, deferring screening for women who present near the time of menses would present similar problems. Given this dilemma, it is important to determine whether the advantages of liquid-based cytology methods, such as increased cellular recovery and reduction of obscuring by blood (Bernstein et al, 2001), eliminate the association between the performance of cytology and LMP that has been demonstrated for smears.Similarly, the implement...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Performance of cytology and human papillomavirus testing in relation to the menstrual cycle

2006

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“…Of 17 studies in Japan, HPV prevalence was generally low, with 12 studies reporting a prevalence of less than 15% [115,118,[121][122][123][124][125][126][127][129][130][131]. In Australia, four populations [87-91] reported prevalences ranging from 6% in women with a mean age of 19 years (range ¼ 13-44 years) [89] to 41% in women aged 18 to 20 years [87,88] (Table 1). No data were reported from New Zealand.…”

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confidence: 99%

Age-Specific Prevalence of Infection with Human Papillomavirus in Females: A Global Review

Smith

Melendy

Rana

et al. 2008

Journal of Adolescent Health

282

219

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“…Wheeler et al (1996) reported no significant correlation in HPV detection and phase of menstrual cycle, although the point prevalence of HPV in the follicular phase was higher than in the luteal phase. Fairley et al (1994) performed a study to determine if HPV detection or the size of the tampon specimen was effected by the menstrual cycle. They concluded from their study that the timing of the menstrual cycle effects the size of tampon specimens but not the probability of detecting HPV DNA.…”

Section: Clinicalmentioning

confidence: 99%

Fluctuations in prevalence of cervical human papillomavirus in women frequently sampled during a single menstrual cycle

et al. 2002

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In the last few years much attention has been focused on the implementation of human papillomavirus detection in population based screening programmes to identify women at risk for cervical cancer. Short-term fluctuations in prevalence of human papillomavirus were investigated within a single menstrual cycle. The highest prevalence was found at the follicular phase (55%), whereas the cumulative prevalence was 75%. (Schiffman et al, 1993;Chichareon et al, 1998;Ngelangel et al, 1998; Liaw et al, 1999;Walboomers et al, 1999;Andersson et al, 2001;Lehtinen et al, 2001). A systematic review on the role of HPV testing within a cervical cancer screening program showed that the high risk HPV prevalence in CIN 1 ranged from 30 to 65%, in CIN 2 from 40 to 70% and in CIN 3 from 60 to 90% (Cuzick et al, 1999). Furthermore, HPV can be detected in almost all cervical carcinomas (Walboomers et al, 1999).The estimated point prevalences of genital HPV infections detected by PCR based methods among populations of women with cytological normal cervical smears range from 1.5 to 44.3%, with a weighted average of 16.2% (Xi and Koutsky, 1997) and show an age-related pattern (Melkert et al, 1993). The highest prevalences are found in women in their early twenties (de Villiers et al, 1992;Melkert et al, 1993). Newly acquired genital HPV is usually transient in women with normal cervical cytology (Evander et al, 1995). The mean duration of cervical HPV infection in a healthy population varies between 8.2 -13.5 months (Ho et al, 1998;Franco et al, 1999). Short-term fluctuations of an individual's HPV status, however, are still a matter of debate. Several studies have reported a fluctuating expression of HPV (Ho et al, 1998;Schneider et al, 1992;Wheeler et al, 1996), probably due to differences in viral load, inadequate sampling or reactivation of endogenous infection (Woodman et al, 2001). Single point measurements of HPV 16 in cervical smears are of limited value for assessment of an individual's HPV status .Before incorporation of HPV testing in screening programs for prevention of cervical cancer it is important to gain more insight in the actual prevalence of HPV, influenced by short-term fluctuations. The aim of this study was to investigate the presence of cervical HPV in the different phases of a single menstrual cycle in women with regular cycles. MATERIALS AND METHODSCervical samples for HPV detection and cytological examination were obtained from 20 women visiting the outpatient clinic for fertility problems at the University Medical Centre Nijmegen, the Netherlands. Only women with regular menstrual cycles were included. Patients with cervical treatment for abnormal cervical cytology in the past 10 years were not included in the study. After giving informed consent, patients were interviewed regarding their medical history, smoking habits, use of contraceptives and sexual behaviour.Cervical smears for HPV detection and cytological classification were obtained using the Cervex brush (Rovers, Oss, the Netherlands).On a weekly bas...

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The detection of HPV DNA, the size of tampon specimens and the menstrual cycle.

Cited by 12 publications

References 12 publications

Performance of cytology and human papillomavirus testing in relation to the menstrual cycle

Performance of cytology and human papillomavirus testing in relation to the menstrual cycle

Age-Specific Prevalence of Infection with Human Papillomavirus in Females: A Global Review

Fluctuations in prevalence of cervical human papillomavirus in women frequently sampled during a single menstrual cycle

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