Toward 70% cervical cancer screening coverage: Technical challenges and opportunities to increase access to human papillomavirus (HPV) testing

Kundrod, Kathryn; Jerónimo, José; Vetter, Beatrice; Maza, Mauricio; Murenzi, Gad; Phoolcharoen, Natacha; Castle, Philip E.

doi:10.1371/journal.pgph.0001982

Cited by 7 publications

(2 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The development of cervical cancer is closely linked to persistent infection with 13-14 high-risk types of the human papillomavirus (HRHPV) [3][4][5]. Currently, molecular detection of these specific HPV types is the globally recommended primary screening method [6][7][8]. Primary HPV-based cervical cancer screening programs aim to identify precancerous lesions at an early stage, preventing their progression to cervical cancer with remarkable sensitivity [9,10].…”

Section: Introductionmentioning

confidence: 99%

Triage Strategies for Non-16/Non-18 HPV-Positive Women in Primary HPV-Based Cervical Cancer Screening: p16/Ki67 Dual Stain vs. Cytology

Mazurec,

Trzeszcz,

Mazurec

et al. 2023

Cancers

View full text Add to dashboard Cite

Background: In the context of primary HPV cervical cancer screening, the identification of minor screening abnormalities necessitates triage tests to optimize management and mitigate overtreatment. Currently, reflex cytology and reflex p16/Ki67 dual-stain (DS) are under scrutiny for their applicability in primary HPV-based screening. However, there remains a dearth of comprehensive data for comparing their performance. Methods: Among 30,066 results from liquid-based cervical cancer screening tests, a cohort of 332 cases was meticulously selected based on available high-risk human papillomavirus (HPV) test results, limited genotyping for HPV 16 and 18, liquid-based cytology, DS, and histology outcomes from standardized colposcopy with biopsy. For cases positive for 12 other high-risk HPV genotypes, three retrospective triage approaches were analyzed. We computed the positive predictive value (PPV) for the detection of high-grade squamous intraepithelial lesions or worse (HSIL+). Results: Both triage models employing DS (reflex cytology followed by DS and reflex DS alone in all cases) exhibited significantly higher PPV for HSIL+ compared to the strategy with reflex cytology alone (35.9%/33.3% vs. 18.8%; p < 0.0001). Additionally, these DS-based models showed higher negative predictive values (NPV) (100%/96.2% vs. 69.2%; p = 0.0024/0.0079). In the DS-inclusive models, fewer colposcopies were necessitated (103/102 vs. 154), and fewer cases of HSIL+ were overlooked (0/3 vs. 8). Conclusions: Our findings suggest that p16/Ki67 dual-stain, either as a standalone or combined triage test, holds promise for the effective detection of HSIL+ in patients with minor screening abnormalities in primary HPV-based cervical cancer screening.

show abstract

Section: Introductionmentioning

confidence: 99%

Triage Strategies for Non-16/Non-18 HPV-Positive Women in Primary HPV-Based Cervical Cancer Screening: p16/Ki67 Dual Stain vs. Cytology

Mazurec,

Trzeszcz,

Mazurec

et al. 2023

Cancers

View full text Add to dashboard Cite

show abstract

“…In addition, the International HPV Laboratory Network conducts proficiency testing for laboratories using commercially available HPV-based tests as well as the in-house assays 3 . However, the cost-intensiveness of these assays, the requirement of an extensive laboratory set-up with high-end equipment and the delay in report generation (usually due to the batch system of sample processing) have hindered the utility and application of HPV-based cervical cancer screening in the low- and low-middle income countries 4 . Hence, there has been a felt need for the development of cost-effective point-of-care (POC) or near-POC methods for HPV detection in cervical samples.…”

mentioning

confidence: 99%

Point-of-care tests for human papillomavirus detection in uterine cervical samples: A review of advances in resource-constrained settings

Gupta,

Gupta

2023

Indian Journal of Medical Research

View full text Add to dashboard Cite

Incidence of cervical cancer and associated mortality are still high in resource-constrained countries due to the lack of infrastructural facilities and trained workforce. Human papillomavirus (HPV)-based screening tests offer a better sensitivity (>90%) for the detection of cervical high-grade lesions. However, these tests usually require an extensive laboratory set-up and trained technical staff. Moreover, the high cost of the currently available and approved HPV tests precludes their use in the cervical cancer screening programmes in resource-limited settings. Hence, there is a felt need for a low-cost point-of-care (POC) HPV test with good performance characteristics to help augment cervical cancer screening in such settings. A recent meta-analysis demonstrated a good sensitivity and specificity for two of the commercially available POC HPV tests. The present review discusses the merits and limitations of the current commercially available POC and near-POC devices for HPV-based cervical cancer screening. The technologies that have the potential to be developed into low-cost POC tests and newer promising modalities for HPV-based POC or near POC have also been highlighted. This review underscores the need for collaborative and coordinated research for development of POC or near-POC HPV-based tests to be used in cervical cancer screening. Efforts need to be focussed on technologies that offer ease of performance without the requirement of sophisticated equipment or extensive sample pre-processing coupled with a good sensitivity and cost-effectiveness.

show abstract

An Audit of Patients referred after Hysterectomy for Carcinoma Cervix to a Cancer Institute in Northern India

Singh

2024

Indian J Gynecol Oncolog

View full text Add to dashboard Cite

Toward 70% cervical cancer screening coverage: Technical challenges and opportunities to increase access to human papillomavirus (HPV) testing

Cited by 7 publications

References 55 publications

Triage Strategies for Non-16/Non-18 HPV-Positive Women in Primary HPV-Based Cervical Cancer Screening: p16/Ki67 Dual Stain vs. Cytology

Triage Strategies for Non-16/Non-18 HPV-Positive Women in Primary HPV-Based Cervical Cancer Screening: p16/Ki67 Dual Stain vs. Cytology

Point-of-care tests for human papillomavirus detection in uterine cervical samples: A review of advances in resource-constrained settings

An Audit of Patients referred after Hysterectomy for Carcinoma Cervix to a Cancer Institute in Northern India

Contact Info

Product

Resources

About