Protecting the underscreened women in developed countries: the value of HPV test

Background: Poor attendance to cervical cancer (CC) screening is a major risk factor for CC. Efforts to capture underscreened women are considerable and once women agree to participate, the provision of longitudinal validity of the screening test is of paramount relevance. We evaluate the addition o...

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Autores: Ibáñez, Raquel, Autonell, Josefina, Sarda, Montserrat, Crespo, Nàyade, Pique, Pilar, Pascual, Amparo, Martí, Clara, Fibla, Montserrat, Gutiérrez Miguélez, Cristina, Lloveras Rubio, Betlem, Moreno Crespi, Judit, Torrent, Anna, Baixeras, Núria, Alejo, Maria, Bosch José, Francesc Xavier, 1947-, Sanjosé Llongueras, Silvia de
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2014
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/124383
Acceso en línea:https://hdl.handle.net/2445/124383
Access Level:acceso abierto
Palabra clave:Papil·lomavirus
Càncer de coll uterí
Papillomaviruses
Cervix cancer
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spelling Protecting the underscreened women in developed countries: the value of HPV testIbáñez, RaquelAutonell, JosefinaSarda, MontserratCrespo, NàyadePique, PilarPascual, AmparoMartí, ClaraFibla, MontserratGutiérrez Miguélez, CristinaLloveras Rubio, BetlemMoreno Crespi, JuditTorrent, AnnaBaixeras, NúriaAlejo, MariaBosch José, Francesc Xavier, 1947-Sanjosé Llongueras, Silvia dePapil·lomavirusCàncer de coll uteríPapillomavirusesCervix cancerBackground: Poor attendance to cervical cancer (CC) screening is a major risk factor for CC. Efforts to capture underscreened women are considerable and once women agree to participate, the provision of longitudinal validity of the screening test is of paramount relevance. We evaluate the addition of high risk HPV test (HPV) to cervical cytology as a primary screening test among underscreened women in the longitudinal prediction of intraepithelial lesions grade 2 or worse (CIN2+). Methods: Women were included in the study if they were older than 39 years and with no evidence of cervical cytology in the previous five years within the Public Primary Health Care System in Catalonia (Spain). 1,832 underscreened women from eight public primary health areas were identified during 2007-2008 and followed-up for over three years to estimate longitudinal detection of CIN2+. Accuracy of each screening test and the combination of both to detect CIN2+ was estimated. The risk of developing CIN2+ lesions according to histology data by cytology and HPV test results at baseline was estimated using the Kaplan-Meier method. Results: At baseline, 6.7% of participants were HPV positive, 2.2% had an abnormal cytology and 1.3% had both tests positive. At the end of follow-up, 18 out of 767 (2.3%) underscreened women had a CIN2+, two of which were invasive CC. The three-year longitudinal sensitivity and specificity estimates to detect CIN2+ were 90.5% and 93.0% for HPV test and 38.2% and 97.8% for cytology. The negative predictive value was >99.0% for each test. No additional gains in validity parameters of HPV test were observed when adding cytology as co-test. The referral to colposcopy was higher for HPV but generated 53% higher detection of CIN2+ compared to cytology. Conclusions: Underscreened women had high burden of cervical disease. Primary HPV screening followed by cytology triage could be the optimal strategy to identify CIN2+ leading to longer and safe screen intervals.BioMed Central2018201820142018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion8 p.application/pdfhttps://hdl.handle.net/2445/124383Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1186/1471-2407-14-574BMC Cancer, 2014, vol. 14, num. 574https://doi.org/10.1186/1471-2407-14-574info:eu-repo/grantAgreement/EC/FP7/242061cc by (c) Ibáñez et al., 2014http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1243832026-05-29T05:05:01Z
dc.title.none.fl_str_mv Protecting the underscreened women in developed countries: the value of HPV test
title Protecting the underscreened women in developed countries: the value of HPV test
spellingShingle Protecting the underscreened women in developed countries: the value of HPV test
Ibáñez, Raquel
Papil·lomavirus
Càncer de coll uterí
Papillomaviruses
Cervix cancer
title_short Protecting the underscreened women in developed countries: the value of HPV test
title_full Protecting the underscreened women in developed countries: the value of HPV test
title_fullStr Protecting the underscreened women in developed countries: the value of HPV test
title_full_unstemmed Protecting the underscreened women in developed countries: the value of HPV test
title_sort Protecting the underscreened women in developed countries: the value of HPV test
dc.creator.none.fl_str_mv Ibáñez, Raquel
Autonell, Josefina
Sarda, Montserrat
Crespo, Nàyade
Pique, Pilar
Pascual, Amparo
Martí, Clara
Fibla, Montserrat
Gutiérrez Miguélez, Cristina
Lloveras Rubio, Betlem
Moreno Crespi, Judit
Torrent, Anna
Baixeras, Núria
Alejo, Maria
Bosch José, Francesc Xavier, 1947-
Sanjosé Llongueras, Silvia de
author Ibáñez, Raquel
author_facet Ibáñez, Raquel
Autonell, Josefina
Sarda, Montserrat
Crespo, Nàyade
Pique, Pilar
Pascual, Amparo
Martí, Clara
Fibla, Montserrat
Gutiérrez Miguélez, Cristina
Lloveras Rubio, Betlem
Moreno Crespi, Judit
Torrent, Anna
Baixeras, Núria
Alejo, Maria
Bosch José, Francesc Xavier, 1947-
Sanjosé Llongueras, Silvia de
author_role author
author2 Autonell, Josefina
Sarda, Montserrat
Crespo, Nàyade
Pique, Pilar
Pascual, Amparo
Martí, Clara
Fibla, Montserrat
Gutiérrez Miguélez, Cristina
Lloveras Rubio, Betlem
Moreno Crespi, Judit
Torrent, Anna
Baixeras, Núria
Alejo, Maria
Bosch José, Francesc Xavier, 1947-
Sanjosé Llongueras, Silvia de
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Papil·lomavirus
Càncer de coll uterí
Papillomaviruses
Cervix cancer
topic Papil·lomavirus
Càncer de coll uterí
Papillomaviruses
Cervix cancer
description Background: Poor attendance to cervical cancer (CC) screening is a major risk factor for CC. Efforts to capture underscreened women are considerable and once women agree to participate, the provision of longitudinal validity of the screening test is of paramount relevance. We evaluate the addition of high risk HPV test (HPV) to cervical cytology as a primary screening test among underscreened women in the longitudinal prediction of intraepithelial lesions grade 2 or worse (CIN2+). Methods: Women were included in the study if they were older than 39 years and with no evidence of cervical cytology in the previous five years within the Public Primary Health Care System in Catalonia (Spain). 1,832 underscreened women from eight public primary health areas were identified during 2007-2008 and followed-up for over three years to estimate longitudinal detection of CIN2+. Accuracy of each screening test and the combination of both to detect CIN2+ was estimated. The risk of developing CIN2+ lesions according to histology data by cytology and HPV test results at baseline was estimated using the Kaplan-Meier method. Results: At baseline, 6.7% of participants were HPV positive, 2.2% had an abnormal cytology and 1.3% had both tests positive. At the end of follow-up, 18 out of 767 (2.3%) underscreened women had a CIN2+, two of which were invasive CC. The three-year longitudinal sensitivity and specificity estimates to detect CIN2+ were 90.5% and 93.0% for HPV test and 38.2% and 97.8% for cytology. The negative predictive value was >99.0% for each test. No additional gains in validity parameters of HPV test were observed when adding cytology as co-test. The referral to colposcopy was higher for HPV but generated 53% higher detection of CIN2+ compared to cytology. Conclusions: Underscreened women had high burden of cervical disease. Primary HPV screening followed by cytology triage could be the optimal strategy to identify CIN2+ leading to longer and safe screen intervals.
publishDate 2014
dc.date.none.fl_str_mv 2014
2018
2018
2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/124383
url https://hdl.handle.net/2445/124383
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/1471-2407-14-574
BMC Cancer, 2014, vol. 14, num. 574
https://doi.org/10.1186/1471-2407-14-574
info:eu-repo/grantAgreement/EC/FP7/242061
dc.rights.none.fl_str_mv cc by (c) Ibáñez et al., 2014
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Ibáñez et al., 2014
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 8 p.
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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