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Population-based primary HPV mRNA cervical screening compared with cytology screening.
Lindroth, Ylva; Borgfeldt, Christer; Thorn, Gunilla; Bodelsson, Gunilla; Forslund, Ola.
Afiliación
  • Lindroth Y; Department of Laboratory Medicine, Medical Microbiology, Lund University, Sweden.
  • Borgfeldt C; Department of Obstetrics and Gynaecology at Skåne University Hospital, Lund University, Sweden.
  • Thorn G; Department of Laboratory Medicine, Clinical Genetics and Pathology, Lund, Sweden.
  • Bodelsson G; Department of Laboratory Medicine, Clinical Genetics and Pathology, Lund, Sweden.
  • Forslund O; Department of Laboratory Medicine, Medical Microbiology, Lund University, Sweden. Electronic address: ola.forslund@med.lu.se.
Prev Med ; 124: 61-66, 2019 07.
Article en En | MEDLINE | ID: mdl-31047910
Primary HPV screening for cervical cancer by HPV mRNA testing (Aptima) was implemented in January 2017, for women ≥30 through 70 years, in the Region of Skåne, Sweden. HPV positive samples underwent cytology assessment, and women with any degree of abnormal cytology were referred for colposcopy. The aim was to audit the primary HPV screening program, by comparing the cytology results to those of corresponding women (aged ≥30 through 65 years) screened with conventional cytology during 2016. Overall, HPV was detected among 7.0% (4433/63,055) of the women ≥30-70 years in the primary HPV screening program. Among a co-tested (cytology and HPV) subgroup aged 40-42 years (N = 5039), HPV was detected in 100% (28/28) of high-grade squamous intraepithelial lesions (HSIL) and atypical squamous cells of undetermined significance (ASCUS) where HSIL could not be excluded (ASCH) (9/9), and in 80% (4/5) of cases of atypical glandular cells (AGC). Among women ≥30-65 years, the proportion ASCUS or worse (ASCUS+) was similar with cytology (3.52% [2016]) and primary HPV screening (3.70% [2017]). Only the proportion of ASC-H changed by the use of primary HPV screening, from 0.13% (2016) to 0.23% (2017) (p < 0.001). The colposcopy referral rate increased by 54% (3.70 vs 2.41%), when primary HPV screening was introduced. In conclusion, the implemented primary HPV screening approach demonstrated similar prevalence of ASCUS+ cytology as conventional screening. In addition, primary HPV screening decreased cytology assessments by 86% in our screening population of women 30 through 70 years taken into account the co-tested women.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Frotis Vaginal / Neoplasias del Cuello Uterino / Infecciones por Papillomavirus / Detección Precoz del Cáncer Tipo de estudio: Diagnostic_studies / Risk_factors_studies / Screening_studies Límite: Adult / Aged / Female / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Prev Med Año: 2019 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Frotis Vaginal / Neoplasias del Cuello Uterino / Infecciones por Papillomavirus / Detección Precoz del Cáncer Tipo de estudio: Diagnostic_studies / Risk_factors_studies / Screening_studies Límite: Adult / Aged / Female / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Prev Med Año: 2019 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos