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Evaluation of oncogenic human papillomavirus RNA and DNA tests with liquid‐based cytology in primary cervical cancer screening: The FASE study
Author(s) -
Monsonego Joseph,
Hudgens Michael G.,
Zerat Laurent,
Zerat JeanClaude,
Syrjänen Kari,
Halfon Philippe,
Ruiz Fabrice,
Smith Jennifer S.
Publication year - 2010
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.25726
Subject(s) - colposcopy , medicine , hybrid capture , cytology , cervical cancer , liquid based cytology , cervical intraepithelial neoplasia , human papillomavirus , gynecology , cervical screening , triage , papillomaviridae , oncology , obstetrics , cancer , pathology , emergency medicine
The APTIMA® HPV Assay (AHPV) allows detection of 14 high‐risk human papillomavirus (HPV) RNA types in cervical specimens. Until present, the assay has been compared to HPV DNA tests only in triage settings. Herein, we compare AHPV with a DNA assay (Hybrid Capture® 2; HC2) and liquid‐based cytology (LBC; using PreservCyt® ThinPrep liquid Pap) in a screening setting (French APTIMA screening evaluation [FASE] study). Women ( N = 5,006) aged 20–65 were screened by gynecologists in 17 private practices in Paris, France. One cervical specimen was collected and tested with LBC, AHPV and HC2 assays. Women were referred to colposcopy if they were ASC‐US+ in LBC or HPV positive in either HPV assay. To control for verification bias, a random group (14%) with normal LBC and dually HPV negative tests underwent colposcopy. Data from 4,429 women were analyzed. Sensitivity, specificity and predictive values were calculated for the three tests. AHPV and HC2 were highly sensitive for CIN2+ (92.0% and 96.7%) and CIN3+ (95.7% and 95.3%) detection and much more sensitive than LBC (69.1% for CIN2+ and 73.3% for CIN3+). Specificity of AHPV was higher than that of HC2, but similar to that of LBC ( p < 0.001). Combining LBC with either HPV test slightly increased sensitivity but compromised specificity. AHPV assay is both specific and sensitive for the detection of high‐grade precancerous lesions and may be considered as an option for routine cervical cancer screening for women over 20 years of age.