HPV16/18 genotyping for the triage of HPV positive women in primary cervical cancer screening in Chile

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dc.contributor.authorLagos Lucero, Marcela
dc.contributor.authorVan De Wyngard, Vanessa
dc.contributor.authorPoggi, Helena
dc.contributor.authorCook, María Paz
dc.contributor.authorViviani García, Paola
dc.contributor.authorBarriga Cosmelli, María Isabel
dc.contributor.authorFerreccio Readi, Catterina
dc.contributor.authorPruyas, Martha
dc.contributor.authorLagos Lucero, Marcela
dc.contributor.authorVan De Wyngard, Vanessa
dc.contributor.authorPoggi, Helena
dc.contributor.authorCook, María Paz
dc.contributor.authorViviani, Paola
dc.contributor.authorBarriga, María I.
dc.contributor.authorFerreccio Readi, Catterina
dc.contributor.authorPruyas, Martha
dc.date.accessioned2019-10-17T15:44:29Z
dc.date.available2019-10-17T15:44:29Z
dc.date.issued2015
dc.date.updated2019-10-14T18:51:36Z
dc.description.abstractAbstract Background We previously conducted a population-based screening trial of high-risk human papillomavirus (hrHPV) testing and conventional cytology, demonstrating higher sensitivity (92.7 % vs 22.1 % for CIN2+) but lower positive predictive value (10.5 % vs 23.9 %) of hrHPV testing. Here we report the performance of HPV16/18 genotyping to triage the hrHPV positive participants. Methods Women aged 25 years and older received hrHPV (Hybrid Capture 2) and Papanicolaou testing; positives by either test underwent colposcopy and directed biopsy, as did a sample of double-negatives. hrHPV positive women were reflex-tested with HPV16/18 genotyping (Digene HPV Genotyping PS Test). Results Among the 8,265 participants, 10.7 % were hrHPV positive, 1.7 % had ASCUS+ cytology, 1.2 % had CIN2+; 776 (88 %) hrHPV positive women had complete results, of whom 38.8 % were positive for HPV16 (24.0 %), HPV18 (9.7 %) or both (5.1 %). CIN2+ prevalence in HPV16/18 positive women (16.3 %, 95 % CI 12.3-20.9) was twice that of HPV16/18 negative women (8.0 %, 95 % CI 5.7-10.8). HPV16/18 genotyping identified 40.5 % of CIN2, 66.7 % of CIN3 and 75.0 % of cancers. Compared to hrHPV screening alone, HPV16/18 triage significantly reduced the referral rate (10.7 % vs 3.7 %) and the number of colposcopies required to detect one CIN2+ (9 vs 6). When HPV16/18 negative women with baseline ASCUS+ cytology were also colposcopied, an additional 14 % of CIN2+ was identified; referral increased slightly to 4.2 %. Conclusions HPV16/18 triage effectively stratified hrHPV positive women by their risk of high-grade lesions. HPV16/18 positive women must be referred immediately; referral could be deferred in HPV16/18 negative women given the slower progression of non-HPV16/18 lesions, however, they will require active follow-up.Abstract Background We previously conducted a population-based screening trial of high-risk human papillomavirus (hrHPV) testing and conventional cytology, demonstrating higher sensitivity (92.7 % vs 22.1 % for CIN2+) but lower positive predictive value (10.5 % vs 23.9 %) of hrHPV testing. Here we report the performance of HPV16/18 genotyping to triage the hrHPV positive participants. Methods Women aged 25 years and older received hrHPV (Hybrid Capture 2) and Papanicolaou testing; positives by either test underwent colposcopy and directed biopsy, as did a sample of double-negatives. hrHPV positive women were reflex-tested with HPV16/18 genotyping (Digene HPV Genotyping PS Test). Results Among the 8,265 participants, 10.7 % were hrHPV positive, 1.7 % had ASCUS+ cytology, 1.2 % had CIN2+; 776 (88 %) hrHPV positive women had complete results, of whom 38.8 % were positive for HPV16 (24.0 %), HPV18 (9.7 %) or both (5.1 %). CIN2+ prevalence in HPV16/18 positive women (16.3 %, 95 % CI 12.3-20.9) was twice that of HPV16/18 negative women (8.0 %, 95 % CI 5.7-10.8). HPV16/18 genotyping identified 40.5 % of CIN2, 66.7 % of CIN3 and 75.0 % of cancers. Compared to hrHPV screening alone, HPV16/18 triage significantly reduced the referral rate (10.7 % vs 3.7 %) and the number of colposcopies required to detect one CIN2+ (9 vs 6). When HPV16/18 negative women with baseline ASCUS+ cytology were also colposcopied, an additional 14 % of CIN2+ was identified; referral increased slightly to 4.2 %. Conclusions HPV16/18 triage effectively stratified hrHPV positive women by their risk of high-grade lesions. HPV16/18 positive women must be referred immediately; referral could be deferred in HPV16/18 negative women given the slower progression of non-HPV16/18 lesions, however, they will require active follow-up.
dc.fuente.origenBiomed Central
dc.identifier.citationInfectious Agents and Cancer. 2015 Nov 23;10(1):43
dc.identifier.doi10.1186/s13027-015-0038-5
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/26790
dc.issue.numeroNo. 43
dc.language.isoen
dc.pagina.final6
dc.pagina.inicio1
dc.revistaInfectious Agents and Canceres_ES
dc.rightsacceso abierto
dc.rights.holderLagos et al.
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.otherEnfermedades infecciosases_ES
dc.subject.otherCáncer de cuello uterinoes_ES
dc.subject.otherVirus del papiloma humanoes_ES
dc.subject.otherCitología Técnicaes_ES
dc.titleHPV16/18 genotyping for the triage of HPV positive women in primary cervical cancer screening in Chilees_ES
dc.typeartículo
dc.volumenVol. 10
sipa.codpersvinculados72982
sipa.codpersvinculados142427
sipa.codpersvinculados729
sipa.codpersvinculados846
sipa.codpersvinculados99684
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