HPV DNA testing improves CIN2+ risk stratification and detection of CIN2+ in delayed triage of ASCUS and LSIL. A population‐based follow‐up study from Western Norway
In Norway, Pap smears with atypical squamous cells of uncertain significance (ASCUS) and low‐grade squamous intraepithelial lesions (LSIL) are triaged after 6 months. The aim of the study was to evaluate effects of implementing human papillomavirus (HPV) test (2005) in delayed triage of ASCUS and LS...
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| Veröffentlicht in: | Cancer medicine (Malden, MA) MA), 2014-02, Vol.3 (1), p.182-189 |
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| creator | Budal, Elisabeth B. Haugland, Hans K. Skar, Robert Mæhle, Bjørn O. Bjørge, Tone Vintermyr, Olav K. |
| description | In Norway, Pap smears with atypical squamous cells of uncertain significance (ASCUS) and low‐grade squamous intraepithelial lesions (LSIL) are triaged after 6 months. The aim of the study was to evaluate effects of implementing human papillomavirus (HPV) test (2005) in delayed triage of ASCUS and LSIL in a cohort of women from Western Norway. After a survey of 119,469 cervical Pap smears during 2005–2007, a total of 1055 women with an index ASCUS or LSIL were included in the study and followed up for 3–6 years with respect to progression into cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Overall sensitivity for detection of CIN2+ with HPV testing and cytology was 96% and 72%, respectively. The sensitivity for detection of CIN2+ was not affected by age, but the specificity of the HPV test increased with age. Thus, for the age groups 50 years, the specificity of a positive HPV test to detect CIN2+ was 47%, 71%, and 82%, respectively. Positive predictive values for CIN2+ in women with positive cytology, positive HPV test, negative cytology, negative HPV test, or negative HPV and cytology tests were 52%, 41%, 8%, 1.5%, and 0.4%, respectively. HPV testing resulted in a net 22% increased detection of CIN2+. Fifty‐six percent of CIN2+ was detected at an earlier time point with HPV testing in triage. Implementation of HPV testing in delayed triage of ASCUS and LSIL improved the stratification of CIN2+ risk and increased CIN2+ detection and at an earlier time point than with triage by cytology alone.
The effect of implementing human papillomavirus (HPV) testing in delayed triage of ASCUS and low‐grade squamous intraepithelial lesions (LSIL) was studied in a cohort of women from Western Norway. An improved stratification of CIN2+ risk and selection of more clinical relevant lesions was reported on. Also, more CIN2+ was recovered and CIN2+ detected at an earlier time point. |
| doi_str_mv | 10.1002/cam4.171 |
| format | Article |
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The effect of implementing human papillomavirus (HPV) testing in delayed triage of ASCUS and low‐grade squamous intraepithelial lesions (LSIL) was studied in a cohort of women from Western Norway. An improved stratification of CIN2+ risk and selection of more clinical relevant lesions was reported on. Also, more CIN2+ was recovered and CIN2+ detected at an earlier time point.</description><identifier>ISSN: 2045-7634</identifier><identifier>EISSN: 2045-7634</identifier><identifier>DOI: 10.1002/cam4.171</identifier><identifier>PMID: 24403090</identifier><language>eng</language><publisher>United States: John Wiley & Sons Ltd</publisher><subject>Adult ; Aged ; ASCUS ; cervical cancer ; delayed triage ; DNA, Viral - isolation & purification ; Female ; Follow-Up Studies ; HPV ; Humans ; LSIL ; Middle Aged ; Norway ; Original Research ; Papillomaviridae - genetics ; Papillomaviridae - pathogenicity ; Papillomavirus Infections - genetics ; Papillomavirus Infections - pathology ; Papillomavirus Infections - virology ; Pregnancy ; Triage ; Uterine Cervical Dysplasia - diagnosis ; Uterine Cervical Dysplasia - pathology ; Uterine Cervical Neoplasms - diagnosis ; Uterine Cervical Neoplasms - pathology ; Vaginal Smears</subject><ispartof>Cancer medicine (Malden, MA), 2014-02, Vol.3 (1), p.182-189</ispartof><rights>2013 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2013 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.</rights><rights>2013 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930403/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930403/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1411,11541,27901,27902,45550,45551,46027,46451,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24403090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Budal, Elisabeth B.</creatorcontrib><creatorcontrib>Haugland, Hans K.</creatorcontrib><creatorcontrib>Skar, Robert</creatorcontrib><creatorcontrib>Mæhle, Bjørn O.</creatorcontrib><creatorcontrib>Bjørge, Tone</creatorcontrib><creatorcontrib>Vintermyr, Olav K.</creatorcontrib><title>HPV DNA testing improves CIN2+ risk stratification and detection of CIN2+ in delayed triage of ASCUS and LSIL. A population‐based follow‐up study from Western Norway</title><title>Cancer medicine (Malden, MA)</title><addtitle>Cancer Med</addtitle><description>In Norway, Pap smears with atypical squamous cells of uncertain significance (ASCUS) and low‐grade squamous intraepithelial lesions (LSIL) are triaged after 6 months. The aim of the study was to evaluate effects of implementing human papillomavirus (HPV) test (2005) in delayed triage of ASCUS and LSIL in a cohort of women from Western Norway. After a survey of 119,469 cervical Pap smears during 2005–2007, a total of 1055 women with an index ASCUS or LSIL were included in the study and followed up for 3–6 years with respect to progression into cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Overall sensitivity for detection of CIN2+ with HPV testing and cytology was 96% and 72%, respectively. The sensitivity for detection of CIN2+ was not affected by age, but the specificity of the HPV test increased with age. Thus, for the age groups <34 years, 34–50 years, and >50 years, the specificity of a positive HPV test to detect CIN2+ was 47%, 71%, and 82%, respectively. Positive predictive values for CIN2+ in women with positive cytology, positive HPV test, negative cytology, negative HPV test, or negative HPV and cytology tests were 52%, 41%, 8%, 1.5%, and 0.4%, respectively. HPV testing resulted in a net 22% increased detection of CIN2+. Fifty‐six percent of CIN2+ was detected at an earlier time point with HPV testing in triage. Implementation of HPV testing in delayed triage of ASCUS and LSIL improved the stratification of CIN2+ risk and increased CIN2+ detection and at an earlier time point than with triage by cytology alone.
The effect of implementing human papillomavirus (HPV) testing in delayed triage of ASCUS and low‐grade squamous intraepithelial lesions (LSIL) was studied in a cohort of women from Western Norway. An improved stratification of CIN2+ risk and selection of more clinical relevant lesions was reported on. Also, more CIN2+ was recovered and CIN2+ detected at an earlier time point.</description><subject>Adult</subject><subject>Aged</subject><subject>ASCUS</subject><subject>cervical cancer</subject><subject>delayed triage</subject><subject>DNA, Viral - isolation & purification</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>HPV</subject><subject>Humans</subject><subject>LSIL</subject><subject>Middle Aged</subject><subject>Norway</subject><subject>Original Research</subject><subject>Papillomaviridae - genetics</subject><subject>Papillomaviridae - pathogenicity</subject><subject>Papillomavirus Infections - genetics</subject><subject>Papillomavirus Infections - pathology</subject><subject>Papillomavirus Infections - virology</subject><subject>Pregnancy</subject><subject>Triage</subject><subject>Uterine Cervical Dysplasia - diagnosis</subject><subject>Uterine Cervical Dysplasia - pathology</subject><subject>Uterine Cervical Neoplasms - diagnosis</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Vaginal Smears</subject><issn>2045-7634</issn><issn>2045-7634</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNpVUdtu1DAQjRCIVqUSX4D8iISy9S3rzQtSFC5dadkiLYVHaxLbiyGJg510lTc-gd_gt_oleLfbqvjB4_GcOcfjkyQvCZ4RjOlFDS2fEUGeJKcU8ywVc8afPjqfJOch_MBxCUzngjxPTijnmOEcnyZ_Lz9_Re_WBRp0GGy3RbbtvbvRAZXLNX2DvA0_URg8DNbYOu6uQ9AppPSg60PmzBFqu3jbwKQVGryFrd6Xik15vTl0rDbL1QwVqHf92ByIbn__qSBEuHFN43YxHfuoNaoJGe9a9C0-SfsOrZ3fwfQieWagCfr8GM-S6w_vv5SX6erq47IsVmnP2IKkYESVAyeaEKpYRRgoWDDBieEMKshIruuqIqrSoIRRDGrBKpxRUs-FycyCnSVv73j7sWq1qnUXp29k720LfpIOrPy_0tnvcutuJMsZjt8aCV4fCbz7NcYZZGtDrZsGOu3GIEmGF3OR04xG6KvHWg8i9_5EQHoH2NlGTw91guXeerm3XkbrZVl84jGyf_DXpBo</recordid><startdate>201402</startdate><enddate>201402</enddate><creator>Budal, Elisabeth B.</creator><creator>Haugland, Hans K.</creator><creator>Skar, Robert</creator><creator>Mæhle, Bjørn O.</creator><creator>Bjørge, Tone</creator><creator>Vintermyr, Olav K.</creator><general>John Wiley & Sons Ltd</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201402</creationdate><title>HPV DNA testing improves CIN2+ risk stratification and detection of CIN2+ in delayed triage of ASCUS and LSIL. A population‐based follow‐up study from Western Norway</title><author>Budal, Elisabeth B. ; Haugland, Hans K. ; Skar, Robert ; Mæhle, Bjørn O. ; Bjørge, Tone ; Vintermyr, Olav K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p3381-af7b9a41e112d3b13ada83741f43aba519ecbb1dbead7fd3ac73b0521c67f5f83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>ASCUS</topic><topic>cervical cancer</topic><topic>delayed triage</topic><topic>DNA, Viral - isolation & purification</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>HPV</topic><topic>Humans</topic><topic>LSIL</topic><topic>Middle Aged</topic><topic>Norway</topic><topic>Original Research</topic><topic>Papillomaviridae - genetics</topic><topic>Papillomaviridae - pathogenicity</topic><topic>Papillomavirus Infections - genetics</topic><topic>Papillomavirus Infections - pathology</topic><topic>Papillomavirus Infections - virology</topic><topic>Pregnancy</topic><topic>Triage</topic><topic>Uterine Cervical Dysplasia - diagnosis</topic><topic>Uterine Cervical Dysplasia - pathology</topic><topic>Uterine Cervical Neoplasms - diagnosis</topic><topic>Uterine Cervical Neoplasms - pathology</topic><topic>Vaginal Smears</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Budal, Elisabeth B.</creatorcontrib><creatorcontrib>Haugland, Hans K.</creatorcontrib><creatorcontrib>Skar, Robert</creatorcontrib><creatorcontrib>Mæhle, Bjørn O.</creatorcontrib><creatorcontrib>Bjørge, Tone</creatorcontrib><creatorcontrib>Vintermyr, Olav K.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer medicine (Malden, MA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Budal, Elisabeth B.</au><au>Haugland, Hans K.</au><au>Skar, Robert</au><au>Mæhle, Bjørn O.</au><au>Bjørge, Tone</au><au>Vintermyr, Olav K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HPV DNA testing improves CIN2+ risk stratification and detection of CIN2+ in delayed triage of ASCUS and LSIL. A population‐based follow‐up study from Western Norway</atitle><jtitle>Cancer medicine (Malden, MA)</jtitle><addtitle>Cancer Med</addtitle><date>2014-02</date><risdate>2014</risdate><volume>3</volume><issue>1</issue><spage>182</spage><epage>189</epage><pages>182-189</pages><issn>2045-7634</issn><eissn>2045-7634</eissn><abstract>In Norway, Pap smears with atypical squamous cells of uncertain significance (ASCUS) and low‐grade squamous intraepithelial lesions (LSIL) are triaged after 6 months. The aim of the study was to evaluate effects of implementing human papillomavirus (HPV) test (2005) in delayed triage of ASCUS and LSIL in a cohort of women from Western Norway. After a survey of 119,469 cervical Pap smears during 2005–2007, a total of 1055 women with an index ASCUS or LSIL were included in the study and followed up for 3–6 years with respect to progression into cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Overall sensitivity for detection of CIN2+ with HPV testing and cytology was 96% and 72%, respectively. The sensitivity for detection of CIN2+ was not affected by age, but the specificity of the HPV test increased with age. Thus, for the age groups <34 years, 34–50 years, and >50 years, the specificity of a positive HPV test to detect CIN2+ was 47%, 71%, and 82%, respectively. Positive predictive values for CIN2+ in women with positive cytology, positive HPV test, negative cytology, negative HPV test, or negative HPV and cytology tests were 52%, 41%, 8%, 1.5%, and 0.4%, respectively. HPV testing resulted in a net 22% increased detection of CIN2+. Fifty‐six percent of CIN2+ was detected at an earlier time point with HPV testing in triage. Implementation of HPV testing in delayed triage of ASCUS and LSIL improved the stratification of CIN2+ risk and increased CIN2+ detection and at an earlier time point than with triage by cytology alone.
The effect of implementing human papillomavirus (HPV) testing in delayed triage of ASCUS and low‐grade squamous intraepithelial lesions (LSIL) was studied in a cohort of women from Western Norway. An improved stratification of CIN2+ risk and selection of more clinical relevant lesions was reported on. Also, more CIN2+ was recovered and CIN2+ detected at an earlier time point.</abstract><cop>United States</cop><pub>John Wiley & Sons Ltd</pub><pmid>24403090</pmid><doi>10.1002/cam4.171</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged ASCUS cervical cancer delayed triage DNA, Viral - isolation & purification Female Follow-Up Studies HPV Humans LSIL Middle Aged Norway Original Research Papillomaviridae - genetics Papillomaviridae - pathogenicity Papillomavirus Infections - genetics Papillomavirus Infections - pathology Papillomavirus Infections - virology Pregnancy Triage Uterine Cervical Dysplasia - diagnosis Uterine Cervical Dysplasia - pathology Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - pathology Vaginal Smears |
| title | HPV DNA testing improves CIN2+ risk stratification and detection of CIN2+ in delayed triage of ASCUS and LSIL. A population‐based follow‐up study from Western Norway |
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