Age-specific outcomes from the first round of HPV screening in unvaccinated women: Observational study from the English cervical screening pilot.
Cervical cancer
human papillomavirus
outcomes
screening
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
revised:
28
11
2021
received:
06
10
2021
accepted:
03
12
2021
pubmed:
17
12
2021
medline:
22
6
2022
entrez:
16
12
2021
Statut:
ppublish
Résumé
To report detailed age-specific outcomes from the first round of an English pilot studying the implementation of high-risk human papillomavirus (HR-HPV) testing in primary cervical screening. Observational study with screening in 2013-2016, followed by two early recalls and/or colposcopy until the end of 2019. Six NHS laboratory sites. A total of 1 341 584 women undergoing screening with HR-HPV testing or liquid-based cytology (LBC). Early recall tests and colposcopies were recommended, depending on the nature of the screening-detected abnormality. We reported standard screening process indicators, e.g. proportions with an abnormality, including high-grade cervical intraepithelial neoplasia (CIN2+) or cancer, and the positive predictive value (PPV) of colposcopy for CIN2+, by screening test and age group. Among unvaccinated women screened with HR-HPV testing at age 24-29 years, 26.9% had a positive test and 10.4% were directly referred to colposcopy following cytology triage, with a PPV for CIN2+ of 47%. At 50-64 years of age, these proportions were much lower: 5.3%, 1.2% and 27%, respectively. The proportions of women testing positive for HR-HPV without cytological abnormalities, whose early recall HR-HPV tests returned negative results, were similar across the age spans: 54% at 24-29 years and 55% at 50-64 years. Two-thirds of infections at any age were linked to non-16/18 genotypes. Among women with CIN2, CIN3 or cervical cancer, however, the proportion of non-16/18 infections increased with age. As expected, the detection of abnormalities was lower following screening with LBC. These data provide a reliable reference for future epidemiological studies, including those concerning the effectiveness of HPV vaccination. Data from the English pilot study provide a comprehensive overview of abnormalities detected through HPV screening.
Identifiants
pubmed: 34913243
doi: 10.1111/1471-0528.17058
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1278-1288Subventions
Organisme : Public Health England
ID : ODR1718_428
Organisme : Cancer Research UK
ID : C8162/A25356
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C8162/A27047
Pays : United Kingdom
Investigateurs
Tracey-Louise Appleyard
(TL)
Margaret Cruickshank
(M)
Kay Ellis
(K)
Chris Evans
(C)
Viki Frew
(V)
Thomas Giles
(T)
Alastair Gray
(A)
Miles Holbrook
(M)
Katherine Hunt
(K)
Tanya Levine
(T)
Emily McBride
(E)
David Mesher
(D)
Timothy Palmer
(T)
Janet Parker
(J)
Elizabeth Rimmer
(E)
Hazel Rudge Pickard
(HR)
Alexandra Sargent
(A)
David Smith
(D)
John Smith
(J)
Kate Soldan
(K)
Ruth Stubbs
(R)
John Tidy
(J)
Xenia Tyler
(X)
Jo Waller
(J)
Informations de copyright
© 2021 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
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