Detection of cervical precancer and cancer in a hospital population

The aim was to determine the relevance of human papillomavirus (HPV) testing in identifying high-grade cervical intraepithelial neoplasia or worse (CIN2/3+) in a hospital population (n=3574) characterised by a high rate of cytological abnormalities and high-risk HPV infections. According to the resu...

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Bibliographic Details
Published in:European journal of cancer (1990) 2004-05, Vol.40 (8), p.1225-1232
Main Authors: Dalstein, V., Riethmuller, D., Sautière, J.L., Prétet, J.L., Kantelip, B., Schaal, J.P., Mougin, C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Cancer
Cervical Intraepithelial Neoplasia
Colposcopy
DNA, Viral
Female
Follow-Up Studies
Hospitalization
Humans
Life Sciences
Mass Screening
Middle Aged
Papanicolaou Test
Papillomaviridae
Papillomavirus Infections
Precancerous Conditions
Sensitivity and Specificity
Tumor Virus Infections
Uterine Cervical Neoplasms
Vaginal Smears
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Summary:The aim was to determine the relevance of human papillomavirus (HPV) testing in identifying high-grade cervical intraepithelial neoplasia or worse (CIN2/3+) in a hospital population (n=3574) characterised by a high rate of cytological abnormalities and high-risk HPV infections. According to the results of the initial Papanicolaou and HPV test, women were directly referred for colposcopy/biopsy or recalled for a control visit. Sensitivity and specificity were corrected for verification bias. HPV-testing sensitivity was 94.3%, higher than that of cytological testing at any cut-off point (65.1%-86.8%), while specificity was greater for cytology than for HPV testing (99.3% or 91.8% versus 83.4%). The combination of both tests allowed 100% sensitivity and negative predictive value. We conclude that HPV testing is a relevant tool for the detection of cervical disease. The best way of combining cytology and HPV detection in screening programmes should be evaluated in large-scale studies.
ISSN:0959-8049
DOI:10.1016/j.ejca.2004.01.021