Use of a high-risk human papillomavirus DNA test as the primary test in a cervical cancer screening programme

A population-based cohort study

M. Zorzi, A. Del Mistro, A. Farruggio, L. De'Bartolomeis, H. Frayle-Salamanca, L. Baboci, A. Bertazzo, P. Cocco, C. Fedato, M. Gennaro, N. Marchi, M. G. Penon, C. Cogo, A. Ferro

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objective: To present the results of the first 2 years of a human papillomavirus (HPV) test-based screening programme outside the research context. Design: Population-based cohort study. Setting: A cervical service screening programme in Italy. Population: Women aged 25-64 years invited to screening from April 2009 to April 2011. Methods: Eligible women were invited to undergo an HPV test: those with a negative HPV test went on to the next screening episode; those with a positive HPV went on to triage with a Pap smear. Women with positive cytology (i.e. positive for atypical squamous cells of undetermined significance or worse, ASC-US+) were referred to colposcopy, whereas those with negative cytology were referred to repeat HPV testing 1 year later. Main outcome measures: Participation rate, positivity at HPV and at triage, referral rate to colposcopy, positive predictive value for cervical intraepithelial neoplasia grade 2+ (CIN2+) at colposcopy, and detection rate for CIN2+. Results: Participation increased compared with the previous Pap programme (60.6 versus 43.9%). The HPV positivity rate was 7.0; 39.6% of Pap smears were scored as positive, and therefore 2.8% of the women screened were referred for immediate colposcopy. The compliance of women who scored positive for HPV and negative for Pap for repeat HPV testing at 12 months was 78.6%, and the HPV positivity rate was 56.6%. The overall referral rate to colposcopy was 4.6%. The overall detection rate for CIN2+ was 4.5 versus 1.5% of the Pap programme (25-34 years, 8.2%; 35+ years, 3.6%). Conclusions: Compared with the traditional Pap test, the HPV programme recorded a higher response to invitation and an increased DR for CIN2+. The most critical aspects were the reading of cytology in women that were positive for HPV and the increased workload at colposcopy.

Original languageEnglish
Pages (from-to)1260-1268
Number of pages9
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume120
Issue number10
DOIs
Publication statusPublished - Sep 2013

Fingerprint

Human Papillomavirus DNA Tests
Population Control
Early Detection of Cancer
Uterine Cervical Neoplasms
Cohort Studies
Colposcopy
Cervical Intraepithelial Neoplasia
Papanicolaou Test
Cell Biology
Triage
Referral and Consultation
Workload

Keywords

  • Cervical cancer screening
  • HPV DNA test
  • human papillomavirus

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Use of a high-risk human papillomavirus DNA test as the primary test in a cervical cancer screening programme : A population-based cohort study. / Zorzi, M.; Del Mistro, A.; Farruggio, A.; De'Bartolomeis, L.; Frayle-Salamanca, H.; Baboci, L.; Bertazzo, A.; Cocco, P.; Fedato, C.; Gennaro, M.; Marchi, N.; Penon, M. G.; Cogo, C.; Ferro, A.

In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 120, No. 10, 09.2013, p. 1260-1268.

Research output: Contribution to journalArticle

Zorzi, M, Del Mistro, A, Farruggio, A, De'Bartolomeis, L, Frayle-Salamanca, H, Baboci, L, Bertazzo, A, Cocco, P, Fedato, C, Gennaro, M, Marchi, N, Penon, MG, Cogo, C & Ferro, A 2013, 'Use of a high-risk human papillomavirus DNA test as the primary test in a cervical cancer screening programme: A population-based cohort study', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 120, no. 10, pp. 1260-1268. https://doi.org/10.1111/1471-0528.12272
Zorzi, M. ; Del Mistro, A. ; Farruggio, A. ; De'Bartolomeis, L. ; Frayle-Salamanca, H. ; Baboci, L. ; Bertazzo, A. ; Cocco, P. ; Fedato, C. ; Gennaro, M. ; Marchi, N. ; Penon, M. G. ; Cogo, C. ; Ferro, A. / Use of a high-risk human papillomavirus DNA test as the primary test in a cervical cancer screening programme : A population-based cohort study. In: BJOG: An International Journal of Obstetrics and Gynaecology. 2013 ; Vol. 120, No. 10. pp. 1260-1268.
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abstract = "Objective: To present the results of the first 2 years of a human papillomavirus (HPV) test-based screening programme outside the research context. Design: Population-based cohort study. Setting: A cervical service screening programme in Italy. Population: Women aged 25-64 years invited to screening from April 2009 to April 2011. Methods: Eligible women were invited to undergo an HPV test: those with a negative HPV test went on to the next screening episode; those with a positive HPV went on to triage with a Pap smear. Women with positive cytology (i.e. positive for atypical squamous cells of undetermined significance or worse, ASC-US+) were referred to colposcopy, whereas those with negative cytology were referred to repeat HPV testing 1 year later. Main outcome measures: Participation rate, positivity at HPV and at triage, referral rate to colposcopy, positive predictive value for cervical intraepithelial neoplasia grade 2+ (CIN2+) at colposcopy, and detection rate for CIN2+. Results: Participation increased compared with the previous Pap programme (60.6 versus 43.9{\%}). The HPV positivity rate was 7.0; 39.6{\%} of Pap smears were scored as positive, and therefore 2.8{\%} of the women screened were referred for immediate colposcopy. The compliance of women who scored positive for HPV and negative for Pap for repeat HPV testing at 12 months was 78.6{\%}, and the HPV positivity rate was 56.6{\%}. The overall referral rate to colposcopy was 4.6{\%}. The overall detection rate for CIN2+ was 4.5 versus 1.5{\%} of the Pap programme (25-34 years, 8.2{\%}; 35+ years, 3.6{\%}). Conclusions: Compared with the traditional Pap test, the HPV programme recorded a higher response to invitation and an increased DR for CIN2+. The most critical aspects were the reading of cytology in women that were positive for HPV and the increased workload at colposcopy.",
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