Δημοσίευση

Comparison of cytology, HPV DNA testing and HPV 16/18 genotyping alone or combined targeting to the more balanced methodology for cervical cancer screening.

ΤίτλοςComparison of cytology, HPV DNA testing and HPV 16/18 genotyping alone or combined targeting to the more balanced methodology for cervical cancer screening.
Publication TypeJournal Article
Year of Publication2016
AuthorsChatzistamatiou, K., Moysiadis T., Moschaki V., Panteleris N., & Agorastos T.
JournalGynecol Oncol
Volume142
Issue1
Pagination120-127
Date Published2016 07
ISSN1095-6859
Λέξεις κλειδιάAlgorithms, Cervical Intraepithelial Neoplasia, Datasets as Topic, DNA, Viral, Female, Genotype, Human papillomavirus 16, Human papillomavirus 18, Humans, Middle Aged, Papillomavirus Infections, Uterine Cervical Neoplasms
Abstract

OBJECTIVES: The objective of the present study was to identify the most effective cervical cancer screening algorithm incorporating different combinations of cytology, HPV testing and genotyping.METHODS: Women 25-55years old recruited for the "HERMES" (HEllenic Real life Multicentric cErvical Screening) study were screened in terms of cytology and high-risk (hr) HPV testing with HPV 16/18 genotyping. Women positive for cytology or/and hrHPV were referred for colposcopy, biopsy and treatment. Ten screening algorithms based on different combinations of cytology, HPV testing and HPV 16/18 genotyping were investigated in terms of diagnostic accuracy.RESULTS: Three clusters of algorithms were formed according to the balance between effectiveness and harm caused by screening. The cluster showing the best balance included two algorithms based on co-testing and two based on HPV primary screening with HPV 16/18 genotyping. Among these, hrHPV testing with HPV 16/18 genotyping and reflex cytology (atypical squamous cells of undetermined significance - ASCUS threshold) presented the optimal combination of sensitivity (82.9%) and specificity relative to cytology alone (0.99) with 1.26 false positive rate relative to cytology alone.CONCLUSION: HPV testing with HPV 16/18 genotyping, referring HPV 16/18 positive women directly to colposcopy, and hrHPV (non 16/18) positive women to reflex cytology (ASCUS threshold), as a triage method to colposcopy, reflects the best equilibrium between screening effectiveness and harm. Algorithms, based on cytology as initial screening method, on co-testing or HPV primary without genotyping, and on HPV primary with genotyping but without cytology triage, are not supported according to the present analysis.

DOI10.1016/j.ygyno.2016.04.027
Alternate JournalGynecol. Oncol.
PubMed ID27126005

Επικοινωνία

Τμήμα Ιατρικής, Πανεπιστημιούπολη ΑΠΘ, T.K. 54124, Θεσσαλονίκη
 

Συνδεθείτε

Το τμήμα Ιατρικής στα κοινωνικά δίκτυα.
Ακολουθήστε μας ή συνδεθείτε μαζί μας.