Objective: To report detailed age-specific outcomes from the first round of an English pilot studying the implementation of high-risk human papillomavirus (HR-HPV) testing in primary cervical screening.
Design: Observational study with screening in 2013-2016, followed by two early recalls and/or colposcopy until the end of 2019.
Setting: Six NHS laboratory sites.
Population: A total of 1 341 584 women undergoing screening with HR-HPV testing or liquid-based cytology (LBC).
Methods: Early recall tests and colposcopies were recommended, depending on the nature of the screening-detected abnormality.
Main Outcome Measures: We reported standard screening process indicators, e.g. proportions with an abnormality, including high-grade cervical intraepithelial neoplasia (CIN2+) or cancer, and the positive predictive value (PPV) of colposcopy for CIN2+, by screening test and age group.
Results: Among unvaccinated women screened with HR-HPV testing at age 24-29 years, 26.9% had a positive test and 10.4% were directly referred to colposcopy following cytology triage, with a PPV for CIN2+ of 47%. At 50-64 years of age, these proportions were much lower: 5.3%, 1.2% and 27%, respectively. The proportions of women testing positive for HR-HPV without cytological abnormalities, whose early recall HR-HPV tests returned negative results, were similar across the age spans: 54% at 24-29 years and 55% at 50-64 years. Two-thirds of infections at any age were linked to non-16/18 genotypes. Among women with CIN2, CIN3 or cervical cancer, however, the proportion of non-16/18 infections increased with age. As expected, the detection of abnormalities was lower following screening with LBC.
Conclusions: These data provide a reliable reference for future epidemiological studies, including those concerning the effectiveness of HPV vaccination.
Tweetable Abstract: Data from the English pilot study provide a comprehensive overview of abnormalities detected through HPV screening.
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http://dx.doi.org/10.1111/1471-0528.17058 | DOI Listing |
Sci Rep
January 2025
Department of Pathology, School of Medical Sciences, Clinical Teaching Center, University of Cape Coast, Private Mail Bag, Cape Coast, Ghana.
Cervical cancer continues to disproportionately burden women in sub-Saharan Africa, and is the commonest gynecological cancer in Ghana. The Cervical Cancer Prevention and Training Centre (CCPTC), Battor, Ghana spearheaded the Ghana arm of the mPharma 10,000 Women Initiative (mTTWI) between September 2021 and October 2022. The aim of this study was to examine the outcomes of nationwide concurrent screening using high-risk human papillomavirus (hr-HPV) DNA testing and visual inspection methods, as well as factors associated with the screening outcomes.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
: Implementing self-sampling (SS) in cervical cancer screening requires comparable results to clinician-collected samples (CCS). Agreement measures are essential for evaluating HPV test performance. Previous studies on non-paired samples have reported higher viral cycle threshold (Ct) values in SS compared to CCS, affecting sensitivity for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+).
View Article and Find Full Text PDFPLoS One
January 2025
Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Background: Risk of anal cancer is high in certain populations and screening involves collection of anal swabs for HPV DNA and/or cytology testing. However, barriers exist, such as the need for an intimate examination, and stigma around HIV status, sexual orientation, and sexual practices. Self-collected anal swabs (SCA) are a proposed alternative to clinician-collected swabs (CCA) to overcome these barriers.
View Article and Find Full Text PDFJ Virol Methods
December 2024
Scottish HPV Reference Laboratory, NHS Lothian, Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SA, United Kingdom; HPV Research Group, University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom.
Background: Self-sampling is now a key component within HPV-based cervical screening programmes to engage individuals and enhance participation. As self-sampling is relatively new, information on the influence of pre-analytical parameters such as transit-temperature and time between sampling and testing on HPV test results requires detailed investigation.
Methods: FLOQSwabs® and Evalyn Brushes® were used to assess HPV and cellular stability over a 30-week period (0w,4w,12w,30w) at 4 °C, ambient, and 37 °C.
BMC Cancer
December 2024
Department of Gynecology, the Third Xiangya Hospital of Central South University, No.138 Tongzipo Road, Hunan, 410013, China.
Objective: To assess the clinical value of DNA methylation measurement in exfoliated cervical cells for distinguishing high-grade squamous intraepithelial lesions (HSIL) from other cervical abnormalities.
Methods: A total of 276 patients were enrolled, and general clinical information was collected. Exfoliated cervical cells were obtained to assess human papillomavirus (HPV) infection, conduct ThinPrep cytology tests (TCT), and measure methylation levels of JAM3 (△CtJ) and PAX1 (△CtP).
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