Cervical cancer screening by high risk HPV testing in routine practice: results at one year recall of high risk HPV-positive and cytology-negative women

Cervical cancer screening by human papillomavirus (HPV) testing requires the use of additional triage and follow-up analyses. We evaluated women's compliance with and the performance of this strategy in a routine setting. Five cervical service screening programmes in North-East Italy. Eligible...

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Bibliographic Details
Published in:	Journal of medical screening Vol. 21; no. 1; p. 30
Main Authors:	Del Mistro, Annarosa, Frayle, Helena, Ferro, Antonio, Callegaro, Susanna, Del Sole, Annamaria, Stomeo, Anna, Cirillo, Emanuela, Fedato, Chiara, Pagni, Silvana, Barzon, Luisa, Zorzi, Manuel
Format:	Journal Article
Language:	English
Published:	England 01-03-2014
Subjects:	Adult Cervical Intraepithelial Neoplasia - diagnosis Cervical Intraepithelial Neoplasia - virology Colposcopy - methods Early Detection of Cancer Female Follow-Up Studies Humans Italy Mass Screening - methods Middle Aged Papillomaviridae - isolation & purification Papillomavirus Infections - diagnosis Papillomavirus Infections - virology Predictive Value of Tests Sensitivity and Specificity Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - virology Italy follow-up organized screening triage HPV
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Summary:	Cervical cancer screening by human papillomavirus (HPV) testing requires the use of additional triage and follow-up analyses. We evaluated women's compliance with and the performance of this strategy in a routine setting. Five cervical service screening programmes in North-East Italy. Eligible women aged 25-64 invited for a new screening episode underwent HPV testing for high risk types (hrHPV by Hybrid Capture 2) and cytology triage. Women with positive HPV and cytology results were referred for colposcopy; women with positive HPV but negative cytology results were referred to 1-year repeat hrHPV testing. Of 46,694 women screened by HPV testing up to December 2011, 3,211 (6.9%) tested hrHPV positive; 45% of these had a positive triage cytology. Those with negative cytology were invited for 1-yr repeat testing. Compliance with invitation was 61.6% at baseline and 85.3% at 1-yr repeat. Rate of persistent hrHPV positivity was 58% (830/1,435). Colposcopy performed in women with a positive hrHPV test at 1-yr repeat accounted for 36% of all colposcopies performed within the screening programmes. Cumulatively, a histological high-grade lesion was detected in 276 women (5.9‰ detection rate), 234 at baseline (85%), and 42 (15%) at 1-yr repeat. Compliance with hrHPV-based screening programmes was high both at baseline and at 1-yr repeat. Compared with the randomized trials, a higher proportion of triage cytology was read as positive, and only a small number of high-grade lesions were detected among the group of hrHPV positive cytology negative women who repeated testing 1-yr after baseline.
ISSN:	1475-5793
DOI:	10.1177/0969141314522219