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Cytopathology. 2019 Mar;30(2):150-156. doi: 10.1111/cyt.12652. Epub 2018 Dec 6.

Implementation of HPV-based cervical cancer screening in an organised regional screening programme: 3 years of experience.

Author information

1
Department of Gynaecology and Obstetrics, Päijät Hämeen Central Hospital, Lahti, Finland.
2
Department of Pathology, Fimlab Laboratories Ltd, Tampere, Finland.
3
Department of Microbiology, Fimlab Laboratories Ltd, Tampere, Finland.
4
Department of Gynaecology and obstetrics, Municipal Hospital of Tampere, Tampere, Finland.
5
Science Centre, Tampere University Hospital and Health Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland.
6
Department of Pathology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
7
Department of Gynaecology and Obstetrics, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.

Abstract

OBJECTIVE:

The aim of this study was to evaluate the performance of human papillomavirus (HPV)-based screening in the framework of an organised cervical cancer screening programme.

METHODS:

A total of 46 708 women aged 35-60 years invited to the regional cervical cancer screening programme from 1 January 2012, to 31 December 2014, were enrolled. Overall, 17 770 women were screened by the Abbot RealTime hrHPV test with cytology triage and 15 605 were screened by conventional (Papanicolaou, Pap) cytology. In both groups, women with at least low-grade squamous intraepithelial lesions were referred directly for colposcopy, whereas HPV-positive women with borderline or normal cytology were invited to intensified screening in the following year. In the Pap group, the indication for intensified follow-up was borderline cytology.

RESULTS:

The attendance rate was similar in the HPV and Pap groups (72% and 71%, respectively). Overall, 6.0% of women in the HPV group vs 6.4% in the Pap group were referred to intensified follow-up (relative risk 0.94, 95% confidence interval [CI]: 0.87-1.03). At the index screening years, the relative sensitivity of the HPV test with cytology triage vs conventional screening was 1.64 (95% CI: 1.05-2.55) for CIN2+ and 2.06 (95% CI: 1.17-3.41) for CIN3+. The specificity of the hrHPV test with cytology triage for CIN2+ and CIN3+ was equal to that of the Pap screening (99.2% vs 99.2% for CIN2+ and 99.1% vs 99.1% for CIN3+).

CONCLUSIONS:

Due to its high sensitivity and specificity, primary hrHPV testing with cytology triage seems to be acceptable for cervical cancer screening in an organised setting.

KEYWORDS:

Papanicolaou test; early detection of cancer; mass screening; papillomavirus infections; squamous intraepithelial lesions of the cervix

PMID:
30421573
DOI:
10.1111/cyt.12652

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