Human papillomavirus testing on self-collected samples to detect high-grade cervical lesions in rural Bhutan: The REACH-Bhutan study.
cancer prevention
screening
viral infection
women's cancer
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
revised:
09
01
2023
received:
29
07
2022
accepted:
13
03
2023
medline:
7
6
2023
pubmed:
1
4
2023
entrez:
31
3
2023
Statut:
ppublish
Résumé
"REACH-Bhutan" aimed to evaluate the feasibility and clinical performance of a community-based screening program for cervical cancer in rural Bhutan using self-collected samples for high-risk human papillomavirus (HR-HPV) testing. In April/May 2016, 2590 women aged 30-60 years were screened across rural Bhutan by providing a self-collected sample for careHPV testing. All careHPV-positive women, plus a random sample of careHPV-negative women, were recalled for colposcopy and biopsy. Self-samples also underwent GP5+/6+ polymerase chain reaction (PCR)-based HR-HPV DNA detection and genotyping. Cross-sectional screening indices were estimated against histological high-grade squamous intraepithelial lesions or worse (hHSIL+), including imputation of hHSIL+ in women without colposcopy. HR-HPV positivity was 10.2% by careHPV and 14.8% by GP5+/6+ PCR. Twenty-two cases of hHSIL+ were histologically diagnosed, including one invasive cancer; an additional 7 hHSIL+ were imputed in women without colposcopy. HR-HPV testing by GP5+/6+ showed higher sensitivity for hHSIL+ (89.7%, 95% CI 72.6-97.8) than careHPV (75.9%, 95% CI 56.5-89.7). Negative predictive value was also slightly higher for GP5+/6+ (99.9%, 95% CI 99.6-100) than careHPV (99.7%, 95% CI 99.4-99.9). Specificity, however, was lower for GP5+/6+ (86.1%, 95% CI 84.6-87.4) than careHPV (90.6%, 95% CI 89.4-91.7), as was positive predictive value (6.9%, 95% CI 4.5-9.9 vs. 8.5%, 95% CI 5.4-12.6). Of 377 HR-HPV-positive women by GP5+/6+, 173 (45.9%) were careHPV-positive, including 54.7% HPV16-positive and 30.2% HPV18-positive women. The final REACH-Bhutan results show that screening for cervical cancer with self-collection of samples and HR-HPV testing, in addition to our previous report of achieving high participation, can also perform well to detect women with hHSIL+.
Sections du résumé
BACKGROUND
"REACH-Bhutan" aimed to evaluate the feasibility and clinical performance of a community-based screening program for cervical cancer in rural Bhutan using self-collected samples for high-risk human papillomavirus (HR-HPV) testing.
METHODS
In April/May 2016, 2590 women aged 30-60 years were screened across rural Bhutan by providing a self-collected sample for careHPV testing. All careHPV-positive women, plus a random sample of careHPV-negative women, were recalled for colposcopy and biopsy. Self-samples also underwent GP5+/6+ polymerase chain reaction (PCR)-based HR-HPV DNA detection and genotyping. Cross-sectional screening indices were estimated against histological high-grade squamous intraepithelial lesions or worse (hHSIL+), including imputation of hHSIL+ in women without colposcopy.
RESULTS
HR-HPV positivity was 10.2% by careHPV and 14.8% by GP5+/6+ PCR. Twenty-two cases of hHSIL+ were histologically diagnosed, including one invasive cancer; an additional 7 hHSIL+ were imputed in women without colposcopy. HR-HPV testing by GP5+/6+ showed higher sensitivity for hHSIL+ (89.7%, 95% CI 72.6-97.8) than careHPV (75.9%, 95% CI 56.5-89.7). Negative predictive value was also slightly higher for GP5+/6+ (99.9%, 95% CI 99.6-100) than careHPV (99.7%, 95% CI 99.4-99.9). Specificity, however, was lower for GP5+/6+ (86.1%, 95% CI 84.6-87.4) than careHPV (90.6%, 95% CI 89.4-91.7), as was positive predictive value (6.9%, 95% CI 4.5-9.9 vs. 8.5%, 95% CI 5.4-12.6). Of 377 HR-HPV-positive women by GP5+/6+, 173 (45.9%) were careHPV-positive, including 54.7% HPV16-positive and 30.2% HPV18-positive women.
CONCLUSIONS
The final REACH-Bhutan results show that screening for cervical cancer with self-collection of samples and HR-HPV testing, in addition to our previous report of achieving high participation, can also perform well to detect women with hHSIL+.
Identifiants
pubmed: 36999740
doi: 10.1002/cam4.5851
pmc: PMC10619475
doi:
Substances chimiques
DNA, Viral
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
11828-11837Informations de copyright
© 2023 International Agency for Research on Cancer; licensed by John Wiley & Sons Ltd. Cancer Medicine published by John Wiley & Sons Ltd.
Références
J Low Genit Tract Dis. 2017 Jan;21(1):26-32
pubmed: 27922905
Prev Med. 2020 Jun;135:106076
pubmed: 32247010
Cancer Med. 2023 May;12(10):11828-11837
pubmed: 36999740
Int J Cancer. 2020 Sep 1;147(5):1275-1285
pubmed: 31970767
BMC Womens Health. 2014 Mar 12;14(1):44
pubmed: 24618416
Int J Cancer. 2007 Aug 15;121(4):796-802
pubmed: 17437272
Gynecol Oncol Rep. 2017 Mar 03;20:58-61
pubmed: 28337474
Lancet Oncol. 2019 Feb;20(2):229-238
pubmed: 30658933
Lancet Reg Health Eur. 2021 Nov 09;11:100235
pubmed: 34918001
BMJ. 2018 Dec 5;363:k4823
pubmed: 30518635
Br J Cancer. 2016 Aug 9;115(4):425-30
pubmed: 27434037
J Clin Microbiol. 2006 Feb;44(2):504-12
pubmed: 16455905
Cancer Epidemiol Biomarkers Prev. 2020 Nov;29(11):2261-2268
pubmed: 32856600
Int J Cancer. 2020 Dec 24;:
pubmed: 33368249
Papillomavirus Res. 2020 Jun;9:100198
pubmed: 32416283
Medicine (Baltimore). 2020 Feb;99(6):e19135
pubmed: 32028440
Int J Gynecol Cancer. 2014 Mar;24(3):576-85
pubmed: 24557438
Sex Transm Infect. 2017 Dec;93(S4):S36-S45
pubmed: 29223961
Int J Cancer. 2022 Apr 15;150(8):1350-1356
pubmed: 34850395
Int J Cancer. 2000 Jul 15;87(2):221-7
pubmed: 10861478
Oncotarget. 2017 Aug 2;8(42):72438-72446
pubmed: 29069800
Int J Cancer. 2015 Mar 15;136(6):E743-50
pubmed: 25284599
BMJ Open. 2019 Oct 28;9(10):e029158
pubmed: 31662358
PLoS One. 2019 Jun 19;14(6):e0218559
pubmed: 31216333
Asia Pac J Public Health. 2019 Oct;31(7):652-658
pubmed: 31578073
BMC Womens Health. 2014 Nov 30;14:147
pubmed: 25433538
PLoS One. 2019 Aug 13;14(8):e0220632
pubmed: 31408474
Cancer Med. 2020 Nov;9(22):8701-8712
pubmed: 32966684
BMJ Open. 2020 Mar 30;10(3):e035153
pubmed: 32234744
BMJ Open. 2017 Jul 19;7(7):e016309
pubmed: 28724543
Int J Gynecol Cancer. 2020 Sep;30(9):1292-1297
pubmed: 32737122
PeerJ. 2019 Dec 20;7:e8152
pubmed: 31875147
Int J Gynaecol Obstet. 2021 Jan;152(1):60-67
pubmed: 32347550
J Low Genit Tract Dis. 2018 Jul;22(3):219-224
pubmed: 29570137
Vaccine. 2015 Jul 17;33(31):3726-30
pubmed: 26057136
Int J Cancer. 2020 Jul 1;147(1):128-138
pubmed: 31633801
JAMA Oncol. 2021 Feb 01;7(2):263-270
pubmed: 33377903
J Glob Oncol. 2018 Sep;4:1-7
pubmed: 30241206
Cancer Med. 2022 May;11(9):1984-1994
pubmed: 35257506
Cancer Prev Res (Phila). 2013 Sep;6(9):938-48
pubmed: 23878179
Lancet Oncol. 2008 Oct;9(10):929-36
pubmed: 18805733
Oncotarget. 2017 Jun 30;8(58):97955-97964
pubmed: 29228665
Int J Gynecol Pathol. 2013 Jan;32(1):76-115
pubmed: 23202792
BMC Infect Dis. 2014 Jul 22;14:408
pubmed: 25047665
BMC Womens Health. 2018 Jul 3;18(1):116
pubmed: 29970063
Lancet Glob Health. 2015 Feb;3(2):e85-94
pubmed: 25617202
BMC Womens Health. 2018 Apr 24;18(1):59
pubmed: 29699549